Provider Engagement Coordinator; Quality and Risk Adjustment
Full Time
Remote
Posted
Job description
Join Our Team: Do Meaningful Work and Improve People’s Lives
Our purpose, to improve customers’ lives by making healthcare work better, is far from ordinary. And so are our employees. Working at Premera means you have the opportunity to drive real change by transforming healthcare.
To better serve our customers, we’re creating a culture that promotes employee growth, collaborative innovation, and inspired leadership.
Forbes ranked Premera among America’s 2022 Best Midsize Employers
because we are committed to creating an environment where employees can do their best work and where best-in-class talent comes, stays, and thrives!
COVID-19 Vaccination Policy:
To learn more about our COVID-19 vaccination and accommodation requirements, please visit our Careers landing page.
The Provider Engagement Coordinator develops and maintains relationships with assigned provider accounts with the goal of engaging them in programs that support high quality member care. The PEC also supports Provider Clinical Consulting (PCC) quality, risk adjustment, and medical management program objectives for all lines of business by partnering with PCCs to deliver bi-directional data-sharing solutions, facilitate communication processes between Premera and providers, and update and maintain provider-facing educational tools and platforms. This position partners with Provider Clinical Consultants, the network management team that holds the contractual relationship with providers, the risk adjustment coding team, and the quality team, to execute on provider strategy as directed and to advocate for efficient processes that support effective provider engagement.
What you’ll do:
- Manage effective and positive relationships with assigned providers that foster collaboration and support delivery of high-quality member care. Implement relationship management strategies with assigned providers as well as PCC program providers that focus on effective communication of Premera values, program expectations, and data-sharing.
- Understand and clearly communicate basic concepts related to risk adjustment and documentation and coding best practices; leverage support of PCCs and risk adjustment coding team members as needed for subject matter expertise.
- Understand and clearly communicate HEDIS and Part D measure technical specifications and reporting requirements; leverage support of PCCs and quality team members as needed for subject matter expertise.
- Provide direct support for PCC program objectives by coordinating/scheduling provider meetings, facilitating provider communication processes (notetaking, report delivery, email response and triage, etc.), and coordinating activities and providing direct provider support for data-sharing strategy (new user/provider onboarding, data entry, troubleshooting of user-reported concerns, etc.)
- Coordinate process-oriented provider incentive programs.
- Coordinate updates to provider training materials and program documentation.
- Undertake data management, report creation and basic analyses.
- Support overarching provider engagement program areas by analyzing, interpreting, and auditing processes to identify trends, draw conclusions, ensure compliance, and make recommendations; responds to inquiries regarding project plans, tasks, deliverables, status, process, policies, and procedures to ensure timely completion of deliverables. Proactively identify opportunities and initiating changes/enhancements to project/program documentation and coordination.
- Communicate provider engagement program details through written materials such as proposals, reports, policies, procedures, presentations, correspondence and agendas for clear understanding and facilitation.
- Provides peak-load assistance and back-up as assigned; completes special projects and other duties as assigned.
What you’ll bring:
- Bachelor's degree or four (4) years’ work experience (Required)
- Three (3) years’ experience in an integrated healthcare delivery system environment or working directly with providers (Required)
- Project management experience
- Medical coding and/or HEDIS abstraction experience
#LI-JG1
#LI-Remote
What we offer
- Medical, vision and dental coverage
- Life and disability insurance
- Retirement programs (401K employer match and pension plan)
- Wellness incentives, onsite services, a discount program and more
- Tuition assistance for undergraduate and graduate degrees
- Generous Paid Time Off to reenergize
- Free parking
Equal employment opportunity/affirmative action:
Premera is an equal opportunity/affirmative action employer. Premera seeks to attract and retain the most qualified individuals without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable law.
If you need an accommodation to apply online for positions at Premera, please contact Premera Human Resources via email at careers@premera.com or via phone at 425-918-4785.
The pay for this role will vary based on a range of factors including, but not limited to, a candidate’s geographic location, market conditions, and specific skills and experience.
National Salary Range:
$54,300.00 - $86,900.00
National Plus Salary Range:
$61,400.00 - $98,200.00
- National Plus salary range is used in higher cost of labor markets including Western Washington and Alaska.
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