Provider Engagement Specialist

Lumeris • NH

106d • $72,800 - $97,400

About The Position

At Lumeris, we believe that our greatest achievements are made possible by the talent and commitment of our team members. That's why we are actively seeking talented and collaborative individuals who are passionate about making a difference in the healthcare industry. Join us today as we strive to create a system of care that every doctor wants for their own family and become part of a community that values its people and empowers you to make an impact. The Provider Engagement Specialist is responsible for improving Accountable Care Team (Provider) engagement, establishing significant 'mindshare' within our Accountable Care Team partners including physicians, nurses, administrative staff, and management. This role aims to improve awareness, adoption, and utilization of ADSP related quality and service offerings, positively influencing ACT behavior to empower value-based care, quality, and cost & utilization.

Requirements

• Bachelor's degree or equivalent.
• 3+ years of client-facing experience within the healthcare domain or the knowledge, skills, and abilities to succeed in the role.
• Experience working with physician practices including provider relations, provider education, practice transformation and/or practice management.
• Skilled at change management.
• Demonstrated subject matter expertise in areas such as Medicare advantage, Medicare Shared Savings Program (MSSP), managed care regulations, quality reporting, care management, population management, ACO strategy implementation and operations, and supporting providers in risk-based contracts.
• Strategic and entrepreneurial outlook with strong collaboration skills.
• Ability to guide complex client interactions at C-level.
• Ability to operate in a fast-paced and dynamic environment.
• Team player with excellent communication skills.
• Demonstrated understanding of healthcare metrics and use of analytical skills.
• Extensive knowledge of the U.S. healthcare system.
• Strong client-facing skills.
• Solid presentation skills.

Responsibilities

• Responsible for practice transformation including practice observations, review of findings, best practice recommendations related to a practice's readiness for value-based care.
• Coaches on pre-visit planning and closure of gaps in care.
• Provides high-risk patient follow-up (after inpatient discharge, after ER visit, for complex cases).
• Enhances access to care and referral network optimization.
• Identifies pharmacy management opportunities (promoting generics, medication adherence, step therapy).
• Ensures comprehensive and accurate documentation and coding of risk-adjusted patient populations to ensure appropriate risk score and revenue capture.
• Develops and implements initiatives to improve performance against value-based contract metrics.
• Establishes strong personal relationships with Accountable Care Teams: physicians, nurses, administrative staff, and management.
• Develops and delivers programs, training, and adoption to client.
• Responsible for deliverables of client engagements, including project timelines and logistics.
• Provides subject-matter expertise in program development and solution packaging.
• Keeps abreast of current industry, market, and policy landscape.

Benefits

• Medical, Vision and Dental Plans.
• Tax-Advantage Savings Accounts (FSA & HSA).
• Life Insurance and Disability Insurance.
• Paid Time Off (PTO, Sick Time, Paid Leave, Volunteer & Wellness Days).
• Employee Assistance Program.
• 401k with company match.
• Employee Resource Groups.
• Employee Discount Program.
• Learning and Development Opportunities.

What This Job Offers

• Job Type: Full-time
• Education Level: Bachelor's degree
• Number of Employees: 1,001-5,000 employees