Why Choose Jefferson Health Plans?

We are an award-winning, not-for-profit health maintenance organization offering Medicaid, Medicare, and Children’s Health Insurance Program (CHIP) plans that include special benefits to improve the health and wellness of our members. We are committed to creating a community where everyone belongs, acknowledges, and celebrates diversity and has opportunities to grow to their fullest potential.

While this job currently provides a flexible remote option, due to in-office meetings, training as required, or other business needs, our employees are to be residents of PA or the nearby states of DE or NJ.

Perks of JHP and why you will love it here:

• Competitive Compensation Packages, including 401(k) Savings Plan with Company Match and Profit Sharing
• Flextime and Work-at-Home Options
• Benefits & Wellness Program including generous Time Off
• Impact on the communities we service

We are seeking a talented and enthusiastic Provider Engagement Specialist to join our team!

Summary/Objective:

Under general supervision of a Provider Outreach and Education Manager, the Provider Engagement Specialist will provide support, education and guidance to an assigned territory of network providers in addition to supporting general education initiatives to the network.

As the Provider Engagement Specialist, your daily duties may include:

• Able to work in a constant state of alertness and safe manner
• Serve as a primary point of contact with both internal and external contacts to facilitate smooth flow of information in order to manage assigned territory with minimal disruption to the provider.
• Provide orientations to all new contracted groups within assigned territory.
• Provide field, telephonic and electronic support to assigned providers.
• Build relationships with providers and their staff in a way that promotes mutual respect and trust.
• Conduct routine face to face meetings with assigned territory of network providers, addressing programs, initiatives, policy changes and issue resolution. Use these meetings to develop strong relationships that build on mutual respect and trust.
• Assist in the development, implementation and facilitation of provider education initiatives via webinar and face-to-face seminars in the community.
• Provide feedback to management, from provider interactions, on educational needs.
• Assist in the development of educational materials.
• Respond to provider and internal inquiries within 24 hours and document actions taken and maintain statistics of calls for reporting purposes.
• Stay current on all company policies, procedures and processes.
• Collaborate with management on all provider facing community activities.
• Responsible for participating in assigned provider outreach projects.
• Working with credentialing and provider data teams conduct reviews of provider related data (Directory proofing) to ensure data standards and integrity are kept to a high level.
• Consistently communicate potential data changes to the credentialing and provider data teams as you become aware of information during the course of your regular interactions with your assigned territory.
• Collaborate with management on activities to aid in growing provider’s membership in emerging HPP territories.
• Develop and maintain positive relationships with team members to ensure a collaborative environment that allows for efficiency and success.
• All other duties as assigned

Qualifications

• Associate’s degree or equivalent healthcare business experience in a provider relations/education environment
• 5 - 7 years managed care experience

Skills, We Value:

• Good working knowledge of Microsoft Office Suite
• Comfortable presenting in front of an audience of peers and superiors
• Exceptional presentation skills
• Effective in a variety of formal presentation settings
• Self-motivator with the ability to work independently and as part of a team
• Ability to meet deadlines and ensure compliance with all company and regulatory requirements
• Ability to prioritize workload and use time effectively and efficiently
• Effective verbal and written communication skills
• Multi-tasking capabilities with high level of organization
• Responds and relates well with employees of all levels
• Uses careful logic and methods to solve difficult problems
• Be a team player, cooperative and encourage collaboration