Provider Engagement Executive

Position Overview

Become a part of our caring community and help us put health first. The Provider Engagement Executive develops and grows positive, long-term relationships with physicians, providers, and healthcare systems to support and improve financial and quality performance within the contracted working relationship with the health plan. This role addresses problems of diverse scope and complexity, ranging from moderate to substantial.

The Provider Engagement Executive represents the scope of health plan/provider relationships across areas such as:

• Financial performance
• Incentive programs
• Quality and clinical management
• Population health
• Data sharing and connectivity
• Documentation and coding
• HEDIS and STARs performance
• Operational improvements
• Provider performance, member experience, market growth, provider experience, and operational excellence.

This position advises executives on developing functional strategies (often segment-specific) on matters of significance. It requires independent judgment and decision-making on complex issues regarding job duties and related tasks, with minimal supervision. The role involves analyzing variable factors to determine the best course of action.

The Provider Engagement Executive will work with key providers in the state, including high-profile hospital and healthcare systems. Experience with relationship building, management, and strategic planning with executive-level leaders at these organizations is required. Regional travel will be an expected part of this role once COVID-19 restrictions have been lifted. Use your skills to make an impact.

Requirements

• Residency: Must reside in the state of Ohio.
• Education: Bachelor's Degree or equivalent work experience.
• Experience:
  • 8 or more years of healthcare or managed care experience with provider contracting, network management, or provider relations.
  • 2 or more years of demonstrated project management experience and partnering with senior leadership on strategic initiatives.
• Skills:
  • Proven planning, preparation, and presenting skills.
  • 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.
  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences.
• Driver Safety Program:
  • Must have a valid state driver's license.
  • Proof of personal vehicle liability insurance with at least 100/300/100 limits.
• Work-at-Home (WAH) Requirements:
  • Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed).
  • A minimum standard speed for optimal performance of 10x1 (10 Mbps download x 1 Mbps upload) is required.

Preferred Qualifications

• Master's Degree.
• Proficiency in analyzing and interpreting financial trends for healthcare costs, administrative expenses, and quality/bonus performance.
• Comprehensive knowledge of Medicare policies, processes, and procedures.

Additional Information

• Travel: Up to 15% travel within the State of Ohio.
• Interview Technology: HireVue will be used as part of the hiring process.
• Home/Hybrid Home/Office Internet Requirements:
  • Minimum download speed of 25 Mbps and upload speed of 10 Mbps is required.
  • Wireless, wired cable, or DSL connection is suggested. Satellite, cellular, and microwave connections are not suitable.

Employment Type

Full time

Location Type

(Information not provided)

Salary

(Information not provided)