Provider Engagement Specialist

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. The Provider Engagement Specialist is responsible for developing and maintaining strong relationships with provider offices to improve network performance, enhance provider satisfaction, and support organizational growth. This role partners with providers on strategies to increase patient retention and growth, while also driving performance across key quality and utilization metrics. The Provider Engagement Specialist serves as the main point of contact for providers, offering education, support, and tools to achieve goals. Job Duties Build and maintain collaborative relationships with providers and their staff to support growth, retention, and performance improvement. Partner with providers to improve performance on key performance indicators (KPIs), including but not limited to growth, retention, Annual Wellness Visits (AWVs), HEDIS gap closures, hospital and ER utilization, risk adjustment and other quality indicators. Conduct initial provider onboarding and provide support for ongoing provider education on Alignment tools, clinical programs, PCP incentives, Member benefit offerings, Model of Care and other compliance requirements, and Alignment initiatives. Assist in the development of training and educational materials/tools. Create provider undefined Facilitate and serve as a single point of resolution for provider issues, including but not limited to UM, prior authorization, claims, encounter data, eligibility, provider rosters and directory validation. Represent Alignment Health at provider meetings, trainings, and community events. Document meeting minutes and action items as needed. Consistently utilize, update and maintain department databases and tracking tools to ensure provider engagement activities, provider visits and outcomes are documented and monitored. Negotiate and implement standard physician and ancillary agreements; obtain provider credentialing; utilize network database to track recruitment activity. Maintain weekly summary of activity and submit reports on a weekly basis. Attend and participate in all staff meetings as required. Perform special projects as assigned. Job Requirements: Experience: Required: Minimum one year of experience in provider relations / contracting with an HMO or IPA, medical group or institutional provider required Preferred: 2+ years of experience in field. Education: Required: High School Diploma or GED. Bachelor's degree or four years additional experience in lieu of education. Preferred: MBA Training: Required: Preferred: Specialized Skills: Required: Proficient user in MS office suite (Word, Excel and PowerPoint). Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others. Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors; Mathematical Skills: Ability to perform mathematical calculations and calculate simple statistics correctly Reasoning Skills: Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution. Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment. Report Analysis Skills: Comprehend and analyze statistical reports. Licensure: Required: Valid Drivers License Preferred: Other: 80% or more travel by car routinely required (In assigned market). Travel by plane required as needed. Maintenance of reliable means of transportation and valid drivers license and automobile insurance required. Extended works hours, as needed. Remote work on approval. Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions Essential Physical Functions: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. 2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus. Pay Range: $54,434.00 - $81,651.00 Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc. Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation. *DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Healths talent acquisition team, please email careers@ahcusa.com. Alignment Health is championing a new path in senior care that empowers members to age well and live their most vibrant lives. Our mission-focused team makes high-quality, low-cost care a reality for members every day. Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most. We believe that great work comes from people who are inspired to be their best. We've built a team of people who want to make a difference in the lives of the seniors we serve. Come join the team that is changing health care one person at a time.