Provider Performance Specialist II (Foster Care)

Company: Home State Health Plan
Location: Joplin
Posted on: June 21, 2022

Job Description:

You could be the one who changes everything for our 26 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.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 meetingsOur Comprehensive Benefits Package:
  • Flexible work solutions including remote options, hybrid work schedules and dress flexibility
  • Competitive pay
  • Paid Time Off including paid holidays
  • Health insurance coverage for you and dependents
  • 401(k) and stock purchase plans
  • Tuition reimbursement and best-in-class training and developmentEducation/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 preferredCentene 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: Home State Health Plan, Joplin , Provider Performance Specialist II (Foster Care), Other , Joplin, Missouri