develops and grows positive, long-term relationships with physicians, providers and healthcare systems
supports and improves financial and quality performance within the contracted working relationship with the health plan
works on problems of diverse scope and complexity ranging from moderate to substantial
represents the scope of health plan/provider relationship across such areas as financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation and coding, HEDIS and Stars performance, operational improvements and other areas as they relate to provider performance, member experience, market growth, provider experience and operational excellence
advises executives to develop functional strategies on matters of significance
exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision

6 or more years of health care or managed care operations to include provider relations and/or provider contracting
Experience working with HEDIS and/or Stars measures and programs
2 or more years of demonstrated project management experience and partnering with senior leadership on strategic initiatives
Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies
Demonstrated ability to manage multiple projects and meet deadlines
Comprehensive knowledge of Medicare policies, processes and procedures
Must reside in either Phoenix, AZ or Denver, CO with the ability to travel as needed, including overnight within the region (CA, NV, AZ, CO, NM)

medical, dental and vision benefits
401(k) retirement savings plan
time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
short-term and long-term disability
life insurance
many other opportunities

Provider Engagement Executive

Key skills