Remote Provider Engagement Specialist (North Carolina)
About The Position
Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. The Provider Engagement Specialist supports the performance and growth objectives of the assigned market by building strong relationships with primary care and specialist providers. This role is responsible for provider outreach, education, contracting support, and ongoing network operations to drive quality outcomes and improve provider performance.
Requirements
- Minimum 1 year of experience in provider relations, contracting, or network management within an HMO, IPA, medical group, or healthcare organization
- Valid driver’s license required
- Reliable transportation and current automobile insurance required
- Proficiency in Microsoft Office (Word, Excel, PowerPoint)
- Strong analytical, problem-solving, and organizational skills
- Ability to manage multiple priorities in a fast-paced environment
- Experience analyzing and interpreting performance data and reports
Nice To Haves
- 2+ years of provider-facing experience, including Medicare lines of business
- Strong understanding of HEDIS, Stars, Risk Adjustment, and MLR
- Bachelor’s degree or equivalent experience preferred
- Strong communication and relationship-building skills
- Ability to present complex healthcare topics to providers
Responsibilities
- Build and maintain collaborative relationships with providers, office staff, and key stakeholders to support network growth and performance
- Conduct provider onboarding, orientations, and ongoing education initiatives
- Perform regular in-person provider visits to review performance metrics and identify improvement opportunities
- Analyze provider performance data and deliver actionable insights to optimize outcomes
- Educate providers on HEDIS, Stars, Risk Adjustment, and documentation/coding requirements
- Develop and implement provider engagement strategies to improve quality scores and member experience
- Support resolution of provider issues related to access, claims, eligibility, and utilization management
- Create and deliver training materials, in-service presentations, and Model of Care trainings
- Maintain accurate provider data and activity tracking in Salesforce and internal systems
- Support provider recruitment, contracting, and credentialing processes
- Negotiate and implement provider agreements in assigned markets
- Track recruitment and contracting activity and provide regular reporting
- Serve as a primary point of contact for provider inquiries, ensuring timely resolution
- Participate in team meetings and contribute to special projects as needed
- Exercise independent judgment and decision-making on complex issues with minimal supervision
Benefits
- Pay Range: $54,434.00 - $81,651.00
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
