Provider Programs Specialist PH Risk Adjustment

Corewell Health • Grand Rapids, MI

5d • Onsite

About The Position

The Provider Programs Specialist is part of the Risk Adjustment department and collaborates across the organization to plan, organize, and implement programs within the provider network. The role develops strategic communications plans and messaging, then creates and distributes communications to internal and external audiences to support provider performance on strategic initiatives.

The specialist supports Risk Adjustment and Coding Documentation Improvement initiatives by coordinating provider engagement, program implementation, performance analysis, and educational communications. The position is based at Priority Health in Grand Rapids and is full time, with a Monday-to-Friday day schedule of 8 a.m. to 5 p.m. and 40 scheduled hours per week.

Requirements

• Bachelor's degree or equivalent.
• Two years of relevant work experience.
• Risk Adjustment-only credential requirement: CPC (Certified Professional Coder) through the American Academy of Professional Coders or CCS (Coding Specialist) through AHIMA, required within 180 days.

Responsibilities

• Partner with internal teams and act as a liaison to providers, community partners, and network stakeholders in support of strategic initiatives, programs, training, and engagement activities.
• Coordinate and manage multiple projects, including scope, timelines, milestones, resource requirements, deliverables, and performance tracking.
• Support the assessment, planning, implementation, and evaluation of programs and interventions intended to improve network efficiency, health outcomes, and patient experience.
• Coordinate implementation and monitoring of clinical pilot programs to ensure program goals, objectives, and deadlines are met.
• Analyze, review, and communicate network performance information related to Risk Adjustment initiatives.
• Develop strategic communications, messaging, and educational materials for internal and external audiences, including provider network partners.
• Support provider-facing engagement activities, including webinars, meetings, trainings, presentations, and other educational events.
• Develop written reports, presentations, and communication materials to support program initiatives and operational goals.
• Collaborate with stakeholders at all organizational levels to plan, implement, and evaluate provider network programs and initiatives.
• Develop strategic communications, messaging, and tactics for the provider network related to Risk Adjustment initiatives and Coding Documentation Improvement efforts.

Benefits

• Comprehensive benefits package supporting financial, health, and work/life balance goals.
• On-demand pay program powered by Payactiv.
• Discounts directory with deals on restaurants, phone plans, spas, and other offerings.
• Optional identity theft protection, home insurance, and auto insurance.
• Traditional and Roth retirement options with service contribution and matching savings.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level