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Alignment Health
Alignment Health
501 – 1000 Darbinieki
ApdrošināšanaVeselības apdrošināšanaVeselības aprūpe
Alignment Health ir veselības apdrošināšanas uzņēmums, kas koncentrējas uz Medicare dalībnieku aprūpes uzlabošanu, jo īpaši senioriem, cilvēkiem ar hroniskām slimībām un cilvēkiem trauslā veselības stāvoklī. Uzņēmums, kas dibināts 2013. gadā, apvieno personalizētu aprūpes modeli ar tehnoloģijām un diennakts konsultatīvās aprūpes komandu, kas koordinē atbalstu ar uzticamiem vietējiem pakalpojumu sniedzējiem. Tā darbība aptver veselības aprūpes pakalpojumu sniegšanu un apdrošināšanu, koncentrējoties uz to, lai aprūpe dalībniekiem būtu pieejamāka, atsaucīgāka un vairāk orientēta uz izmaksām. Alignment Health pieņem darbā darbiniekus augošā veselības aprūpes organizācijā, kas apkalpo Medicare kopienu vajadzības.
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Vakances uzņēmumā

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.

USAmerikas Savienotās ValstisTXTeksasa
54 434 $ – 81 651 $ / gads
HibrīdiPilna slodzeJaunākais speciālistsVidējais līmenisNepieciešamā Valoda: angļuKlientu vadītājsPārdošana

Apraksts

  • 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.

Prasības

  • 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.

Priekšrocības

  • 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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