Senior Provider Engagement Representative (MA) at Bright Health | Powderkeg

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Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.

What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be Collaborative.

If you share our passion for changing healthcare so all people can live healthy, brighter lives – apply to join our team.

The Senior Provider Engagement Representative is responsible for initiating and maintaining relationships with Direct providers and IPA groups to support Stars improvement activities. This position is responsible for assuring accurate provider data is received and processed so Bright Health can effectively provide monitoring, training, education, and resources to providers. The Senior Provider Engagement Representative acts as the Company liaison communicating Bright Health policies and procedures, assisting the Provider with data management, value-based contracting/incentives, program implementations, and delegation oversight related to Stars programs and initiatives. The position requires that the Representative can efficiently and effectively assess the needs of the Providers as it relates to Stars/Quality Improvement and meet those needs in a timely and comprehensive manner. Representatives must possess excellent communication and problem-solving skills along with extensive knowledge of managed care health plan Quality Improvement and Stars.

This position requires the full understanding and active participation in fulfilling the mission of Senior Provider Engagement Representative. It is expected that the employee demonstrates behavior consistent with the core values of Bright Health. The employee will also be expected to support all organizational expectations including, but not limited to: Customer Service, Patient’s Rights, Confidentiality of Information, Bright Health Standards of Conduct, and Bright Health initiatives.

Responsibilities :

  • Possesses a working knowledge of Managed care plans and programs
  • Experienced with Stars and/or Quality Improvement activities
  • Conducts training and education to Providers on CMS Medicare Stars information
  • Conducts Provider Orientations and Training on data management systems, website navigation, and SFTP setup & navigation
  • Conducts site visits to service providers, resolves issues, and educates staff/providers on policies, programs, and initiatives, with a heavy focus on member experience (CAHPS) as well as HEDIS information and Stars initiatives including a variety of specialized health management services provided by Bright Health.
  • Establishes and maintains consistent and strong relationships with provider offices.
  • Represent Bright Health’s network knowledgeably and respectfully.
  • Collaborates with leadership and market to support quality and process improvement activities, review performance, and assist in developing key strategies and initiatives
  • Responsible for overall and market-level member experience activities
  • Assist with organizational and operational strategies to better service the Providers.
  • Special projects as assigned or directed.

Qualifications/ Education/Training Experience:

  • Knowledge of the CMS Medicare Stars program specifically CAHPS (member experience)
  • Minimum two years experience in managed care or other relevant experience
  • Bachelor’s Degree or equivalent experience preferred
  • Superior organizational skills and the ability to handle multiple tasks simultaneously
  • Excellent interpersonal and communication skills, oral and written, with strong presentation skills.
  • Excellent PC and spreadsheet skills
  • A valid Driver’s License

**This position is remote but based in Sacramento, CA. 30% travel required around Northern California. Local candidates only. **

For individuals assigned to a location(s) in California, Bright Health is required by law to include a reasonable estimate of the compensation range for this position. Actual compensation will vary based on the applicant’s education, experience, skills, and abilities, as well as internal equity. A reasonable estimate of the range is $69,0408.00 to $103,571.00 annually.

Additionally, employees are eligible for health benefits; life and disability benefits, a 401(k) savings plan with match; up to 21 days of PTO, 10 paid holidays, plus 2 floating holidays per year; and a lifestyle spending account.

We’re Making Healthcare Right. Together.

We are realizing a completely different healthcare experience where payors, providers, doctors, and patients can all feel connected, aligned and unified on the same team. By eradicating the frictions of competing needs, we are making it possible to give everyone more of what they want and deserve. We do this by:

**Focusing on Consumers
** We understand patient pain points, eliminating complexity while increasing transparency, for greater access and easier navigation.

**Building on Alignment
** We integrate and align individual incentives at all levels, from financing to optimization to delivery of care.

Powered by Technology

We employ our purpose built, integrated data platform to connect clinical, financial, and social data, to deliver exceptional outcomes.

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As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

Job Summary
  • Job Title
    Senior Provider Engagement Representative (MA)
  • Company
    Bright Health
  • Location
    Minneapolis, MN
  • Employment Type
    Full time
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