Provider Performance Specialist II
Company: Oklahoma Complete Health
Location: Stillwater
Posted on: November 19, 2023
|
|
Job Description:
You could be the one who changes everything for our 28 million
members. Centene is transforming the health of our communities, one
person at a time. As a diversified, national organization, you'll
have access to competitive benefits including a fresh perspective
on workplace flexibility.
Oklahoma Complete Health, a Centene company, is committed to
providing quality healthcare solutions to transform the health of
Oklahomans.
At Oklahoma Complete Health, we are community advocates and
change-makers in search of an inclusive culture grounded by our
commitment to work-life balance, competitive compensation, and
continuous career development. Join us and be a part of a
collaborative, growing network of innovative thinkers delivering
solutions at the local level.
***Must Reside in Oklahoma***
Position Purpose: Provide consultative support to providers to
improve their performance on member outreach, utilization
management, cost, quality and risk. Discuss, analyze and interpret
performance reporting, member engagement data and other data
resources to identify opportunities for improving member
outcomes.
Interpret performance data, prioritizing insights and developing
discussion and presentation documents, including year-to-date
results, month-over-month performance, and member engagement
results
Facilitate provider discussions regarding quality, utilization, and
cost or risk performance improvement opportunities, utilizing
corporate tools and reporting
Collaborate with health plan quality counterpart to ensure
coordinated communication and goal alignment for provider
discussions
Develop proficiency in tools and value based performance (VBP) and
educate providers on the use of tools and interpretation of
data
Present detailed HBR (Health Benefits Ratio) analysis and create
reports for Joint Operating Committee meetings
Education/Experience: Bachelor's degree in related field or
equivalent experience. 2+ years of combined managed healthcare and
provider reimbursement experience. Claims processing and/or managed
care experience preferred
Our Comprehensive Benefits Package: Flexible work solutions
including remote options, hybrid work schedules and dress
flexibility, Competitive pay, Paid time off including holidays,
Health insurance coverage for you and your dependents, 401(k) and
stock purchase plans, Tuition reimbursement and best-in-class
training and development.
Centene is an equal opportunity employer that is committed to
diversity, and values the ways in which we are different. All
qualified applicants will receive consideration for employment
without regard to race, color, religion, sex, sexual orientation,
gender identity, national origin, disability, veteran status, or
other characteristic protected by applicable law.
Keywords: Oklahoma Complete Health, Stillwater , Provider Performance Specialist II, Other , Stillwater, Oklahoma
Click
here to apply!
|