Build and maintain collaborative relationships with providers, office staff, and key stakeholders to support network growth and performance
Conduct provider onboarding, orientations, and ongoing education initiatives
Perform regular in-person provider visits to review performance metrics and identify improvement opportunities
Analyze provider performance data and deliver actionable insights to optimize outcomes
Educate providers on HEDIS, Stars, Risk Adjustment, and documentation/coding requirements
Develop and implement provider engagement strategies to improve quality scores and member experience
Support resolution of provider issues related to access, claims, eligibility, and utilization management
Create and deliver training materials, in-service presentations, and Model of Care trainings
Maintain accurate provider data and activity tracking in Salesforce and internal systems
Support provider recruitment, contracting, and credentialing processes
Negotiate and implement provider agreements in assigned markets
Track recruitment and contracting activity and provide regular reporting
Serve as a primary point of contact for provider inquiries, ensuring timely resolution
Participate in team meetings and contribute to special projects as needed
Exercise independent judgment and decision-making on complex issues with minimal supervision
Requirements
Required: Minimum 1 year of experience in provider relations, contracting, or network management within an HMO, IPA, medical group, or healthcare organization
Preferred: 2+ years of provider-facing experience, including Medicare lines of business
Strong understanding of HEDIS, Stars, Risk Adjustment, and MLR
Education
Required: High School Diploma or GED (Bachelor's degree or equivalent experience preferred)
Preferred: MBA
Skills & Competencies
Strong communication and relationship-building skills
Ability to present complex healthcare topics to providers
Proficiency in Microsoft Office (Word, Excel, PowerPoint)
Strong analytical, problem-solving, and organizational skills
Ability to manage multiple priorities in a fast-paced environment
Experience analyzing and interpreting performance data and reports
Licensure & Requirements
Valid driver's license required
Reliable transportation and current automobile insurance required
Work Environment & Travel
Up to 80% travel by car within the assigned market
Occasional air travel as needed
Ability to work extended hours when necessary
Remote work available with approval
Physical Requirements
Regularly required to sit, stand, walk, and use hands for tasks
Ability to lift up to 10 pounds occasionally
Close vision and focus adjustment required
Additional Information
Alignment Healthcare is proud to be an Equal Employment Opportunity and Affirmative Action employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
Pay Range: $54,434.00 - $81,651.00 Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.
Benefits
Health insuranceVision insuranceRemote work options
Additional Information
Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.
Remote -The Provider Engagement Specialist supports the performance and growth objectives of the assigned market by building strong relationships with primary care and specialist providers. This role is responsible for provider outreach, education, contracting support, and ongoing network operations to drive quality outcomes and improve provider performance.
Alignmenthealthcare · Remote