Market Development Advisor

About the Role

Employment Type: Full time

Become a part of our caring community and help us put health first. The Market Development Advisor provides support to assigned health plan and/or specialty companies relative to Medicaid product implementation, operations, contract compliance, and federal contract application submissions. The Market Development Advisor works on problems of diverse scope and complexity ranging from moderate to substantial.

The Market Development Advisor (South Carolina) reports directly to the South Carolina Associate Director and is responsible for strategic and tactical support of the Provider Services team. Responsibilities will include strategic operations of the team, process development and improvement to drive standardization and efficiencies across the team, completing related state reports, and developing and executing upon a provider communication and provider materials development strategy. Initially, the advisor will play a key role in supporting new market implementation activities. This position partners cross-functionally within the market and across the enterprise on matters of significance. This position 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.

Key Role Objectives

• Advise Associate Director regarding Provider Relations and Provider Engagement and Network Operations performance.
• Drives network strategic initiatives and tactical execution, ensuring alignment to financial, operational and clinical goals.
• Establish infrastructure to measure KPIs and other metrics to ensure compliance with related managed care contractual requirements.
• Develop initial and manage annual updates of the market’s Provider Support Plan, in partnership with the Associate Director, as well as any other related required state reporting.
• Oversee provider communications (fax blasts, emails, bulletins, website or provider portal content updates) end-to-end process, including development of content and management through the approval process.
• Manage provider training and education strategy, including advising on and/or creating market-based provider materials and contributing to provider manual and required training materials.
• Monitor performance against key performance indicators and contractual commitments and requirements to ensure compliance.
• Perform root cause research on load inaccuracies that result in provider not reflecting correctly on state provider files and/or directory. Relay to the appropriate department to address the issue.
• Facilitate workgroup calls/meetings/discussions to seek support with data and/or processes that contribute to network strategy and data accuracy success.

Use your skills to make an impact.

Required Qualifications

• Minimum three (3) years of experience, in provider relations or engagement, provider communications and education, and/or related health plan operations.
• Minimum three (3) years of experience with value-based contracting strategy/analysis.
• Minimum two (2) years of process creation or improvement experience.
• Strategic thinker with the ability to identify, prioritize, and solve complex business problems.
• Excellent interpersonal, organizational, written, and oral communication and presentation skills with proven experience writing and delivering presentations to members of the management team and internal business partners.
• Proficient in MS Office Applications including SharePoint, Teams, MS Word, PowerPoint, Outlook, and Excel.
• Excellent written and verbal communication skills.

Preferred Qualifications

• Bachelor's or Master's degree.
• Strong familiarity with SC Medicaid/government healthcare to actively advocate for network priorities with internal stakeholders and shared services.
• Proficiency in Microsoft Access.

Workstyle & Location

• Workstyle: Remote Work at Home
• Location: Prefer South Carolina
• Schedule: M-F 8AM-5PM Eastern Time