Remote Engagement Administrator I - Provider | WFH

Job Overview

We invite you to join our dedicated team, where your contributions will have a meaningful impact on the health and well-being of our communities, supporting 28 million members nationwide. This remote role offers an exceptional opportunity to advance your career while enjoying flexible work arrangements.

Key Responsibilities

• Act as the primary liaison for providers, ensuring effective communication and collaboration with internal partners to resolve provider issues.
• Address external provider inquiries and concerns efficiently and professionally.
• Investigate and communicate updates related to provider claims, ensuring timely resolution and follow-up.
• Manage and update provider demographic information accurately.
• Educate providers on relevant policies and procedures, including referrals, claims submission, and website navigation.
• Conduct thorough provider orientations and ongoing educational sessions, including the creation of associated materials.
• Oversee network performance within your designated area through a consultative account management approach.
• Assess provider performance and craft strategic plans aimed at enhancement.
• Drive improvements in critical performance metrics such as Risk/P4Q, Health Benefit Ratio (HBR), HEDIS, quality, cost, and utilization.
• Complete assigned special projects and undertake additional responsibilities as needed, in compliance with all corporate policies and standards.
• Travel locally up to four days a week as required.
  
  

Required Skills

• Strong communication capabilities.
• Proven ability to investigate and effectively resolve issues.
• Knowledge of healthcare systems, including managed care, Medicare, or Medicaid.
• Familiarity with claims billing and coding is advantageous.
• Excellent organizational and time management skills.
  
  

Qualifications

• A Bachelor's degree in a relevant field or equivalent experience is preferred.
• 0-2 years of professional experience in provider relations, claims/reimbursement, or contracting.
• Essential understanding of healthcare, managed care, Medicare, or Medicaid is critical.
  
  

Career Growth Opportunities

This position not only offers competitive compensation but also provides a platform for professional growth and development. By working with us, you will have the opportunity to expand your professional network and collaborate with industry leaders, fostering your career trajectory.

Company Culture And Values

We pride ourselves on being an equal opportunity employer that values diversity and inclusion. Our organization is committed to creating a work environment where all qualified applicants are welcome and considered, without discrimination based on race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other protected characteristics.

Compensation And Benefits

• Compensation range: \(46,500.00 - \)79,200.00 per year, adjusted based on individual skills, experience, education, and other relevant factors.
• A comprehensive benefits package that includes:
• Health insurance
• 401K and stock purchase plans
• Tuition reimbursement
• Paid time off
• Flexible work arrangements (remote, hybrid, or in-office options).
  

Join us in making a difference in the healthcare landscape while advancing your professional career.

Employment Type: Full-Time