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Provider Engagement Administrator (12)
وصف الوظيفة
The Provider Engagement Administrator plays a pivotal, people-centered role in strengthening partnerships across Carolina Complete Health Network. This position is the frontline connection between the health plan and our diverse network of providers—including hospital systems, local health departments, and advanced medical homes.
المسؤوليات
- Act as a liaison between the provider and the health plan ensuring a coordinated effort in improving financial and quality performance
- Engage providers by soliciting and building on their ideas/interests related to quality performance measurement
- Collaborate with Care Management, Quality and others across the Health Plan and Network
- Educate providers regarding policies and procedures related to referrals, claims submission, web site education, EHR, HIE, and EDI
- Engage providers on Advanced Medical Home / Patient Centered Medical Home initiatives.
- Conduct initial provider orientations as well as ongoing educational outreach for assigned providers
- Identify and deliver solutions to solve significant problems for providers; quantify impact.
- Assist providers in achieving pay-for-performance milestones
- Generate and interpret reports for providers based on detailed HEDIS and/or HBR analysis
- Create and communicate milestone documents, dashboards and success metrics
- Conduct site visits to deepen the collaboration between the provider and the plan(s)
- Protect confidential and sensitive business information, complying with HIPAA
المؤهلات
- Bachelor's degree in related field preferred; or equivalent experience
- 3+ years of project management, provider relations, health care operations, or medical management
- Experience in Managed Healthcare or Medicaid/Medicare industry preferred
- Excellent written, oral, and presentation skills required
- Ability to work collaboratively with staff and contractors at all levels
- Well-developed organizational skills and attention to detail
- High proficiency with Microsoft Office products as well as communication productivity tools
- Current state driver’s license
- Reliable transportation
- Reliable high-speed internet