Field Remote Provider Engagement Specialist Merced/Stanislaus County

Alignment Health•Merced, CA

7d•$58,531 - $87,797•Remote

About The Position

Alignment Health is seeking a proactive, relationship-driven, and highly organized Provider Engagement Specialist to support our growing provider network in Merced/Stanislaus County, CA. In this field-based remote role, you will build strong relationships with physician practices and provider groups, helping improve quality, growth, retention, utilization, and risk adjustment performance while supporting network expansion. This position is ideal for a self-driven professional who enjoys building partnerships, analyzing provider performance, solving problems, and improving healthcare outcomes.

Requirements

Bachelor's degree (B.A. or B.S.) preferred; or equivalent combination of education and experience.
Minimum of two (2) years of related experience and/or training.
Experience in provider relations, provider contracting, network development, healthcare operations, managed care, IPA, HMO, medical group, or institutional provider environments required.
Routinely required to travel by car throughout the assigned market (80% or more).
Must maintain reliable transportation, a valid driver's license, and automobile insurance.
Air travel required as needed.
Extended or flexible work hours may occasionally be required.
Proficiency with Microsoft Office Suite (Word, Excel, and PowerPoint).

Nice To Haves

Bilingual English/Spanish preferred.
Experience working directly with physician practices and healthcare providers.
Knowledge of Medicare Advantage, quality programs, risk adjustment, utilization management, and provider performance metrics.

Responsibilities

Build and maintain collaborative relationships with providers and office staff.
Partner with providers to improve performance in growth, retention, AWVs, HEDIS gap closures, hospital and ER utilization, risk adjustment, and other quality metrics.
Conduct provider onboarding and ongoing education regarding Alignment Health tools, programs, incentives, member benefits, Model of Care requirements, compliance requirements, and organizational initiatives.
Develop provider training materials, implementation packets, and educational presentations.
Serve as the primary point of contact for provider issues, including UM, prior authorizations, claims, eligibility, encounter data, provider rosters, and directory validation.
Represent Alignment Health at provider meetings, trainings, and community events.
Negotiate and implement physician and ancillary agreements and support provider credentialing and recruitment efforts.
Maintain provider engagement documentation, tracking databases, activity reports, and meeting records.
Attend staff meetings and perform special projects as assigned.