Provider Engagement Executive
Description The Provider Engagement Executive develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the contracted working relationship with the health plan.
The Provider Engagement Executive works on problems of diverse scope and complexity ranging from moderate to substantial.
Responsibilities The Provider Engagement Executive represents the scope of health plan/provider relationship across such areas as financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation and coding, HEDIS and STARs performance, operational improvements and other areas as they relate to provider performance, member experience, market growth, provider experience and operational excellence.
Advises executives to develop functional strategies (often segment specific) on matters of significance.
Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action.
Required Qualifications
Bachelor's Degree
8
years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience
2
years of demonstrated project management experience and partnering with senior leadership on strategic initiatives
Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies
Demonstrated ability to manage multiple projects and meet deadlines
Comprehensive knowledge of all Microsoft Office applications
Ability to travel as needed Preferred Qualifications
Masters Degree
Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses and quality/bonus performance
Comprehensive knowledge of Medicare policies, processes and procedures
WAH VA consider, but in office Glen Allen, VA preferred.
Scheduled Weekly Hours 40.
Estimated Salary: $20 to $28 per hour based on qualifications.
The Provider Engagement Executive works on problems of diverse scope and complexity ranging from moderate to substantial.
Responsibilities The Provider Engagement Executive represents the scope of health plan/provider relationship across such areas as financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation and coding, HEDIS and STARs performance, operational improvements and other areas as they relate to provider performance, member experience, market growth, provider experience and operational excellence.
Advises executives to develop functional strategies (often segment specific) on matters of significance.
Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action.
Required Qualifications
Bachelor's Degree
8
years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience
2
years of demonstrated project management experience and partnering with senior leadership on strategic initiatives
Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies
Demonstrated ability to manage multiple projects and meet deadlines
Comprehensive knowledge of all Microsoft Office applications
Ability to travel as needed Preferred Qualifications
Masters Degree
Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses and quality/bonus performance
Comprehensive knowledge of Medicare policies, processes and procedures
WAH VA consider, but in office Glen Allen, VA preferred.
Scheduled Weekly Hours 40.
Estimated Salary: $20 to $28 per hour based on qualifications.
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