Senior Provider Programs Specialist
Senior Provider Programs Specialist
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Salary Not Disclosed
1 Vacancy
Job Description
Job Summary
Under general direction is a liaison for health plan initiatives with physician hospital organizations physician organizations state-wide and community entities. Partners with internal teams to develop and implement strategic initiatives. Manages and coordinates large multi-faceted projects in an organized and cost effective manner. Responsible for all disease burden related activities and driving improvement for the integrated delivery system.
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Essential Functions
Partners with internal teams and serves as a network and community liaison for strategic initiatives training and Programs.
Assesses analyses plans implements and evaluates of multiple interventions programs and data in support of Network efficiency health outcomes and patient experience.
Identifies monitors coordinates and manages multiple projects. This includes project scope targets timelines resource requirements/costs milestones and data requirements.
Creates and prepares accompanying documents and reports.
Coordinates the implementation of clinical pilots to ensure practice commitment to program goals and deadlines.
Monitors results of pilot programs to ensure objectives are achieved.
Responsible for the analysis review and dissemination of network performance information including but not limited to financial quality utilization/satisfaction and/or disease specific.
Develops and delivers or facilitates effective multi media communication strategies meetings trainings and education materials for presentations with a variety of internal and external audiences.
Serves as subject matter expert and resource for researching industry practices sharing best practice and market surveillance information to internal and external customers.
Qualifications
Required
Bachelors Degree
5 years of relevant experience in health plan managed care or healthcare delivery administration or clinical practice management.
Preferred
Knowledge of Health and Population Technology and Provider reporting.
Knowledge of Facets Cactus Health Information Technology and Business Objects Proven experience in planned giving
Clinical experience preferred working in a provider office or delivery system; LPN RN BSN.
Certified Professional Coder CPC or Certified Coding Specialist CCS
Project Management Professional PMP certification
Medicare and ACA Risk Adjustment experience
Proven leadership experience
About Corewell Health
As a team member at Corewell Health you will play an essential role in delivering personalized health care to our patients members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators leaders and innovators that continue to build on one shared mission statement - to improve health instill humanity
How Corewell Health cares for you
Comprehensive benefits package to meet your financial health and work/life balance goals. Learn more here.
On-demand pay program powered by Payactiv
Discounts directory with deals on the things that matter to you like restaurants phone plans spas and more!
Optional identity theft protection home and auto insurance pet insurance
Traditional and Roth retirement options with service contribution and match savings
Eligibility for benefits is determined by employment type and status
Primary Location
SITE - Priority Health - 1231 E Beltline - Grand RapidsDepartment Name
Risk Adjustment ExecutiveEmployment Type
Full timeShift
Day (United States of America)Weekly Scheduled Hours
40Hours of Work
8:00 a.m. to 5:00 p.m.Days Worked
Monday to FridayWeekend Frequency
N/ACURRENT COREWELL HEALTH TEAM MEMBERS Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.
Corewell Health is committed to providing a safe environment for our team members patients visitors and community. We require a drug-free workplace and require team members to comply with the MMR Varicella Tdap and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process to perform the essential functions of a job or to enjoy equal benefits and privileges of employment due to a disability pregnancy or sincerely held religious belief.
Corewell Health grants equal employment opportunity to all qualified persons without regard to race color national origin sex disability age religion genetic information marital status height weight gender pregnancy sexual orientation gender identity or expression veteran status or any other legally protected category.
An interconnected collaborative culture where all are encouraged to bring their whole selves to work is vital to the health of our organization. As a health system we advocate for equity as we care for our patients our communities and each other. From workshops that develop cultural intelligence to our inclusion resource groups for people to find community and empowerment at work we are dedicated to ongoing resources that advance our values of diversity equity and inclusion in all that we do. We invite those that share in our commitment to join our team.
You may request assistance in completing the application process by calling 616.486.7447.
Required Experience:
Senior IC
Employment Type
Full-Time
