Provider Engagement Coordinator

POSITION SUMMARY

This position reports to Provider Engagement Manager. The Provider Engagement Coordinator plays a crucial role in fostering strong, collaborative relationships between the MSO and affiliated Primary Care Providers (PCPs) within a Value-Based Care (VBC) environment. This position acts as the primary liaison for PCPs, ensuring they receive comprehensive support in understanding and improving their performance metrics, adhering to compliance standards, and maximizing their compensation and incentives under Medicare Advantage contracts. The Coordinator is also responsible for promoting provider practices within their communities and assisting with network expansion efforts by identifying and onboarding new providers.

The ideal candidate is detail-oriented, possesses excellent communication skills, and has a strong understanding of VBC principles. This role requires proactive engagement with providers to ensure they have the resources and support needed to deliver high-quality care to their patients while achieving the goals of the MSO.

RESPONSIBILITIES-DUTIES

1.    Liaison for the CMO/Clinical Ops Teams (MSO):

      •     Primary Contact: Serve as the main point of contact for PCPs, facilitating clear and consistent communication between the MSO and affiliated providers.

      •     Support Services: Provide ongoing support to PCPs by addressing their concerns, needs, and questions in a timely and effective manner.

      •     Logistics Support: Assist in the planning and execution of provider touchpoint activities, including meetings, training sessions, and other engagements.

2.    Distribution and Explanation of PCP Scorecards (Future - Provider Dashboards):

      •     Scorecard Distribution: Ensure the timely distribution of PCP scorecards, providing the necessary data for performance evaluation.

      •     Detailed Explanation: Work closely with PCPs to explain the metrics on their scorecards, helping them understand their performance and identify areas for improvement.

3.    Quality Score and Care Gaps Performance:

      •     Performance Monitoring: Track and monitor quality scores and care gaps, providing regular updates and insights to PCPs.

      •     Improvement Plans: Collaborate with PCPs to develop and implement strategies to enhance their quality scores and close care gaps, with support from the Clinical Operations Quality Team.

4.    Risk Adjustment and Compliance Guidance:

      •     Annual Wellness Visits (AWVs): Support PCPs in tracking and ensuring the timely and accurate completion of AWVs, ensuring adherence to compliance standards.

      •     Disease Screenings: Ensure that PCPs are conducting necessary disease screenings in compliance with established guidelines and best practices.

5.    Compensation and Incentive Plan Performance:

      •     Compensation Explanation: Clearly explain the details of compensation and incentive plans to PCPs, ensuring they understand how their performance impacts their earnings.

      •     Performance Tracking: Monitor PCPs’ performance relative to their compensation and incentive plans, providing feedback and follow-up to optimize their outcomes.

6.    Promotion of Practices:

      •     Community Outreach: Actively promote PCP practices within their communities to increase visibility and patient engagement.

      •     Practice Support: Provide guidance and support to help practices attract new patients, enhancing their growth and sustainability.

      •     Co-Promotion Support: Assist in the integration and promotion of new PCPs within the health plan, marketing, and broker networks, ensuring a smooth transition into the IPA.

7.    Sourcing New PCPs/Specialists:

      •     Network Expansion: Identify potential new PCPs and specialists to join the IPA network, focusing on areas with market gaps or opportunities for growth.

      •     Onboarding Support: Assist in the onboarding process for new providers, ensuring they are smoothly integrated into the network and are fully supported from the outset.

8. Event Support:

• PCP meetings/ marketing/ AEP events throughout the year to maintain relationship with the healthplan payors, providers, and broker/agent partners

EDUCATION & EXPERIENCE REQUIREMENTS

• Bachelor’s degree in health care administration or public health administration from an accredited university.
• Ability to manage all aspects of business operations, and effectively various projects within time constraints.
• Attention to detail and take ownership of assigned tasks.
• Must be computer literate and knowledgeable in all Microsoft Office products.
• Effectively interface and successfully cultivate relationships with internal staff, and various business partners; including health plans, hospitals, and health care providers.
• Demonstrated communication, interpersonal, and time management skills. Must be able to make presentations, conduct formal meetings, write business letters and effectively use email to communicate complex ideas.

• Valid driver’s license and/or dependable transportation to work off and on-site is necessary.

• Two years’ experience in IPA or Provider Network administration or comparable managed health care experience preferred.

• Knowledge of health plan managed care agreements and physician and provider agreements preferred.
• Understanding of EMR systems, and benefits management software preferred.

AMM BENEFITS

When you join AMM, you’re not just getting a job—you’re getting a benefits package that puts YOU first:

• Health Coverage You Can Count On: Full employer-paid HMO and the option for a flexible PPO plan.
• Wellness Made Affordable: Discounted vision and dental premiums to help keep you healthy from head to toe.
• Smart Spending: FSAs to manage healthcare and dependent care costs, plus a 401(k) to secure your future.
• Work-Life Balance: Generous PTO, 40 hours of sick pay, and 13 paid holidays to enjoy life outside of work.
• Career Development: Tuition reimbursement to support your education and growth.
• Team Fun: Paid company outings and lunches because we work hard, but we also know how to have fun!