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Alignment Health
Alignment Health
501 – 1 000 Darbuotojai
DraudimasSveikatos draudimasSveikatos priežiūra
„Alignment Health“ yra sveikatos draudimo bendrovė, orientuota į geresnę „Medicare“ sistemos dalyvių priežiūrą, ypač senjorų, lėtinėmis ligomis sergančių ir silpnos sveikatos žmonių. 2013 m. įkurta bendrovė derina individualizuotą priežiūros modelį su technologijomis ir visą parą veikiančia konsultavimo bei priežiūros komanda, kuri koordinuoja pagalbą su patikimais vietos paslaugų teikėjais. Jos veikla apima sveikatos priežiūros paslaugų teikimą ir draudimą, daugiausia dėmesio skiriant tam, kad priežiūra nariams būtų lengviau pasiekiama, operatyvesnė ir labiau orientuota į išlaidas. „Alignment Health“ samdo darbuotojus į augančią sveikatos priežiūros organizaciją, aptarnaujančią „Medicare“ bendruomenių poreikius.
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Provider Relations Manager, Managed Care

Build Alignment Health’s San Antonio provider network through stronger engagement and performance. Support managed-care quality, growth, retention, utilization, and contracting.

USJungtinės ValstijosTXTeksasas
54 434 $ – 81 651 $ / metai
HibridinisVisas etatasJaunesnysis specialistasVidutinis lygisPrivaloma Kalba: anglųKlientų vadybininkasPardavimai

Aprašymas

  • Build collaborative provider relationships that support growth, retention, and performance improvement.
  • Work with providers to improve KPIs such as Annual Wellness Visits, HEDIS gap closures, hospital and ER utilization, risk adjustment, and other quality measures.
  • Onboard providers and educate them on Alignment tools, clinical programs, PCP incentives, member benefits, the Model of Care, compliance, and company initiatives.
  • Help develop training materials and prepare provider in-service and implementation packets.
  • Resolve provider concerns involving utilization management, prior authorization, claims, encounter data, eligibility, rosters, and directory validation.
  • Represent Alignment Health at provider meetings, trainings, and community events; record minutes and action items.
  • Track provider engagement, visits, and outcomes using department databases and tools.
  • Negotiate and implement standard physician and ancillary agreements, secure provider credentialing, and track network recruitment.
  • Prepare weekly activity summaries and reports.
  • Attend staff meetings and complete special projects as assigned.
  • Visit provider offices across San Antonio, Bexar County, nearby areas, and New Braunfels.
  • Prepare provider performance reports and hold regular in-person meetings.

Reikalavimai

  • At least two years of related experience or training, or an equivalent combination of education and experience.
  • Experience in provider relations or contracting with an HMO, IPA, medical group, or institutional provider.
  • Bachelor’s degree or an equivalent combination of education and experience.
  • English and Spanish bilingual skills preferred.
  • Organized, detail-oriented, and self-directed.
  • Strong analytical, quantitative, and problem-solving abilities.
  • Strong verbal and written communication skills.
  • Able to build relationships and work effectively on a team.
  • Strong presentation skills and ability to address diverse audiences effectively.
  • Proficiency with Microsoft Word, Excel, and PowerPoint.
  • Routine travel by car within the assigned market, 80% or more.
  • Air travel as needed.
  • Reliable transportation, a valid driver’s license, and automobile insurance required.
  • Able to work extended hours as needed.

Privalumai

  • Mileage and travel expenses reimbursed under company policy.
  • Opportunities for growth and innovation.
  • Occasional travel for conferences, training, or team meetings.
  • Remote work available with approval.

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USJungtinės Valstijos
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NuotolinisVisas etatasVadovasPrivaloma Kalba: anglųDirbtinis intelektas
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