- Act as a liaison between the provider (Hospital Systems, AMH, Local Health Department and Specialists) and the health plan ensuring a coordinated effort in improving financial and quality performance
- Engage providers to solicit and build on their ideas/interests related to quality performance measurement
- Collaborate with Care Management, Quality and others across the Health Plan and Network
- Educate providers regarding policies and procedures related to referrals, claims submission, web site education, Electronic Health Records, Health Information Exchange, and Electronic Data Interface
- Engage providers on Advanced Medical Home / Patient Centered Medical Home initiatives.
- Conduct initial provider orientations as well as ongoing educational outreach for assigned providers
- Including but not limited to Portal use training including, CAP report retrieval, Quality Dashboards, Claims lookup, and more
- Identify and deliver solutions to solve significant problems for providers; quantify impact.
- Assist providers in achieving pay-for-performance milestones
- Generate and interpret reports for providers based on detailed HEDIS and/or HBR (Health Benefits Ratio) analysis and review provider performance by both quantitative metrics and qualitative factors
- Create and communicate milestone documents, dashboards and success metrics
- Provide status updates for providers regarding incentive agreements
- Conduct site visits to improve quality and financial outcomes
- Collaborate with the Medical Policy Department and others to support policy development and ongoing assessment through provider engagement and other means
- Protect confidential and sensitive business information, complying with Centene in NC firewall system, HIPPA, and CCHN partners
- Perform other duties as delegated
- May require up to 50% travel (local and overnight)
- Bachelor's degree in related field preferred; or equivalent experience
- 3+ years of project management, provider relations, health care operations, or medical management
- Experience in Managed Healthcare or Medicaid/Medicare industry preferred
- Excellent written, oral, and presentation skills required
- Ability to work collaboratively with staff and contractors at all levels
- Well-developed organizational skills and attention to detail
- High proficiency with Microsoft Office products as well as communication productivity tools
- Ability to multitask, prioritize work and adapt to changing priorities
- Must be a self-starter and have a strong sense of urgency
- Should have a strong customer service mindset for supporting both and internal and external customers
- Current state driver's license
-
Executive Assistant
2 weeks ago
East Carolina University Greenville, United StatesThis position functions as the Executive Assistant to the Associate Provost for Learner Operations and also engages in major activities and projects requiring public contact, coordination of some administrative duties involving decision making and ju Executive Assistant, Executiv ...
-
MD/DO - Psychiatry
1 week ago
Vidant/ECU Health- Parent Greenville, United StatesTinkbird Healthcare Staffing is actively seeking a permanent experienced Board Certified Child and Adolescent Psychiatrist to assume the role of Child and Adolescent Residency Program Director for a university in Greenville, NC starting ASAP.Schedule:Full-timeProvider Requirement ...
-
Hayman Daugherty Associates, Inc Greenville, United StatesJob Overview · Telepsychiatry Medical Director in Eastern North Carolina · A major state university located in eastern North Carolina is seeking a BC Adult Psychiatrist for the position of medical director of telepsychiatry and e-Behavioral Health. The physician will provide serv ...
-
PT Store Events Coordinator Team Member
2 weeks ago
Michaels Stores Greenville, United StatesStore - GREENVILLE, NC · Plan, coordinate, and facilitate events (including kids birthday parties) within a Michaels store to provide a stress-free, fun, and engaging experience for guests. Deliver friendly customer service by helping customers shop at our store and find what th ...
-
Quility Insurance Greenville, United StatesMedical Director, Center for Telepsychiatry and E-Behavioral Health Adult Psychiatry · SPECIALITY: Psychiatry - Academic · CANDIDATE TYPE: MD / DO · EMPLOYMENT TYPE: Full Time · VISA ACCEPTED: No J-1 or H-1B · Job Description · We are seeking a BE/BC?Psychiatrist to serve as the ...
-
Eastern Regional Coordinator
1 day ago
North Carolina Museum of Art Foundation Greenville, United StatesJob Type · Part-time · Description · Designed by asking key questions about rural communities, opportunity, and innovation, the Artist Innovation Mentorship program (NCMA AIM) strives to make a positive impact on the lives of youth and to welcome them into the NCMA community by ...
-
Certified Medical Assistant, Full-time
3 weeks ago
Proactive Greenville, United States Full timePeople are a company's greatest resource, which is why caring for employees and keeping them healthy is so important. Proactive MD offers a comprehensive health management solution that extends well beyond the clinic walls. Access to on-site physicians, full direct primary care s ...
-
School Psychologist
2 weeks ago
Public School of North Carolina Greenville, United StatesPosition Title: School Psychologist · Reports To: Exceptional Children Director or Designee · Term of Employment: 10 months · Knowledge & Skills Required: · * Knowledge of the delivery of psychological services consistent with the ethical principles and professional standards set ...
-
School Psychologist
1 week ago
Public School of North Carolina Greenville, United StatesPosition Title: School Psychologist · Reports To: Exceptional Children's Director or Designee · Supervises: None · Term of Employment: 10 months · Knowledge & Skills Required: · * Knowledge of the delivery of psychological services consistent with the ethical principles and profe ...
-
Coordinator for Fraternity and Sorority Life
2 weeks ago
East Carolina University Greenville, United StatesPosting Details · Position Information · Job Title · Coordinator for Fraternity and Sorority Life · Position Number · 000751 · Vacancy Open to · All Candidates · Department · SAH Student Center Operations · Department Homepage · Advertising Department · GREEK LIFE · Division · ...
-
Administrative Assistant
3 weeks ago
Trillium Health Resources Greenville, United StatesPay Plan Title: Administrative Assistant · Working Title: Receptionist · Posting Salary Range: $31,200 - $35,000 · Office Location: Office based- 201 West 1st Street, Greenville, NC 27858 · POSTING DETAILS: · Make an Impact · Trillium Health Resources is a local governmenta ...
-
Human Resources Business Partner
2 weeks ago
Conexus Recruiting Greenville, United StatesTitle: HRBP/HR ManagerCompensation: $130-150k + BonusLocation: Near Greenville, SC · We are partnering with a global client in the logistics and supply chain space that is seeking a strategic HRBP to be "Head of HR" for one of their large distribution centers. They offer tons of ...
-
Retention Business Development Manager
3 weeks ago
Altice USA Greenville, United StatesAre you looking to Optimize your life? Start your exciting path to a rewarding career today · We are Optimum, a leader in the fast-paced world of connectivity, and we're on the hunt for enthusiastic professionals to join our team We understand that connectivity isn't just a luxu ...
-
Career Advisor-Temporary
1 week ago
East Carolina University Greenville, United StatesPosting Details · Position Information · Job Title · Career Advisor-Temporary · Position Number · TN · Vacancy Open to · All Candidates · Department · AAH College of Engineering and Tech · Department Homepage · Advertising Department · COLLEGE OF ENGINEERING AND TECHNOLOGY · ...
-
Director of Development
2 weeks ago
Greenville Symphony Orchestra Greenville, United StatesGreenville Symphony AssociationDirector of DevelopmentPOSITION SUMMARY · The Director of Development is a results-driven collaborative leader, guiding the Greenville Symphony Orchestra (GSO) in developing and executing an innovative fund development program, including annual fun ...
-
Administrative Assistant
2 weeks ago
Trillium Health Resources Greenville, United StatesPay Plan Title: Administrative Assistant · Working Title: Receptionist · Posting Salary Range: $31,200 - $35,000 · Office Location: Office based- 201 West 1st Street, Greenville, NC 27858 · POSTING DETAILS: · Make an Impact · Trillium Health Resources is a local governmenta ...
-
Board Member
1 week ago
Provider Healthcare Greenville, NC, United StatesA child and adolescent Psychiatrist is needed in a thriving multidisciplinary clinic to serve both clinical and administrative duties. Preference is given to candidates who have worked in an academic healthcare setting and with a clinical research background. · Growing 9-hospita ...
-
Sr. Director of Philanthropy
2 weeks ago
Vidant Health Greenville, United StatesJob Description · ECU Health · ECU Health Foundation · East Carolina University ("ECU") and Vidant Health entered into a Joint Operating Agreement on January 1, 2022 to create ECU Health to achieve greater economies of scale, improve the value of care provided, efficiently all ...
-
Community Manager
2 weeks ago
RR Living Greenville, United StatesCommunity Manager · Our mantra is simple -- love. Love what you do. Love where you live. Love the success and return we provide. At RR Living, we are a part of something special. · The Community Manager should have excellent leadership skills and maintain exemplary communication ...
-
Vidant Health Greenville, United StatesJob Description · ECU Health · About ECU Health · ECU Health is a mission-driven, 1,708-bed academic health care system serving more than 1.4 million people in 29 eastern North Carolina counties. The not-for-profit system is comprised of 13,000 team members, nine hospitals and ...
Provider Engagement Administrator - Greenville, United States - CCHN
Description
Provider Engagement AdministratorOffice Locations: Greenville, NC / Homebased position
Position Purpose: Reporting to the Director of Provider Engagement, the Provider Engagement Administrator will serve as a liaison between the health plan and network providers, community partners and other stakeholders. This position is responsible for adding value to the network and plan through building and maintaining strong relationships with network providers and serving as a resource and support mechanism to promote the quadruple aim. As a key-member of a cross-functional, dynamic team, the Provider Engagement Administrator will serve as a key driver in supporting the PE goals of satisfaction, improved performance, advocacy and move to value.
Key Responsibilities