Market Development Advisor

Employment Type: Full-time

Position Overview

The Market Development Advisor provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE/Employer Group 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 Michigan Provider Services Advisor 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.

Responsibilities

• Advise Provider Services Associate Director on strategic and day-to-day operations of the overall Provider Services team, which includes provider relations and provider engagement.
• Establish infrastructure to measure KPIs and other metrics to ensure compliance with related 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.
• Prior to market go-live, contribute to implementation of contractual requirements and day-to-day business processes/functions.
• Lead process development or improvement and rollout to team members to drive efficiency, standardization, and best practices.
• Drive development of ad-hoc strategic initiatives to execute on the Provider Journey, Provider Relationship Management model, and other strategic initiatives.
• Facilitate workgroup calls/meetings/discussions to ensure successful execution of Provider Support Plan.
• Partner with corporate Medicaid Provider Services team to rollout new segment-wide process or technology enhancements in support of the overall Provider Services team.

Requirements

• Bachelor's degree or equivalent experience of 6 years.
• 3+ years of related experience, including provider relations or engagement, provider communications and education, and/or related health plan operations.
• 2+ years of project management experience.
• Strategic thinker with the ability to identify, prioritize, and solve complex business problems.
• Strong attention to detail.
• 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.

Preferred Qualifications

• Master’s degree.
• Experience working in Medicaid.
• Understanding of managed care contracts, including contract language and reimbursement.
• Familiarity with DSNP/Medicaid-Medicare integration.
• Strong understanding of health plan operations.
• Experience operating in a matrixed environment.
• Project management certification.

Company Information

Become a part of our caring community and help us put health first.