Senior Provider Engagement Dedicated Care Manager - Virginia Beach/Norfolk VA

Profile

Description

The Senior Provider Engagement Dedicated Care Manager develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the contracted working relationship with the health plan. The Senior Provider Engagement, Clinical Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Responsibilities

The Senior Provider Engagement Dedicated Care Manager 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, operational improvements and other areas as they relate to provider performance, member experience, market growth, provider experience and operational excellence. This work focuses on areas of clinical emphasis. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.

Required Qualifications


BSN or RN
Nursing license unrestricted in the state of Virginia
5 years of experience working as a registered nurse
Excellent Communication and presentation skills
Excellent Organizational skills with ability to work independently
Well versed in Microsoft office, Excel and PowerPoint
Valid driver's license with reliable transportation and the ability to travel within the region


Preferred Qualifications


3-5 years of managed care experience
3-5 years of case management experience
Experience managing clinical performance in Value Based contract
HEDIS knowledge
Experience with Medicare STARs program


Additional Information

As we return to our offices, this role will sit onsite at one of our key hospital partner locations in the Virginia Beach/Norfolk/Tidewater area up to 3 days per week.

Scheduled Weekly Hours

40

Company info

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