Virginia Premier Health Plan Provider Engagement Coordinator in Glen Allen, Virginia

About Us

Don’t just find a job, find your WHY at a purpose-driven organization; discover a career at Virginia Premier.

By blending quality benefits, affiliating with the world-renowned VCU Health System and offering career-advancing development programs, we allow our employees to focus on the meaningful work of improving and saving the lives of more than 200,000 people throughout the state of Virginia.

At Virginia Premier, we are building an industry leading health care organization through dedicated teams that have heart, provide top-notch quality member services and embrace our mission of inspiring healthy living within the communities we serve. Our vision is to connect people to innovation, quality and affordable health care for all phases of life.

If this sounds like you, read on!

Overview

The Provider Engagement Coordinator will support the Director, and Senior Manager, Quality and all related activities that result in the closing of HEDIS care gaps. The Quality Provider Engagement Coordinators are responsible for member education face to face in provider offices, distributing incentive gift cards for closing targeted care gaps, collecting medical records for HEDISabstractions to support year -long HEDIS efforts and referring members to Case and/or Disease management when needed. This position requires travel up to 80% per week servicing providers that see Medicaid, Medicare and LTSS members.

Responsibilities

  • Follows the direction of the Director, and Sr. Manager, Quality in the implementation of wellness days in provider offices

  • Coordinate with Provider Relations identify providers for quality engagement and to conduct Virginia Premier Wellness Days at key provider offices to close care gaps

  • Coordinate with Health Education to reach out to members telephonically to schedule them for appointments and assist with setting up transportation, when needed

  • Collect medical records after each Wellness Day and give to the Sr. HEDIS Manager to load into the HEDIS administrative database year-long

  • Participate in the Member Advisory and Provider Advisory Meetings as needed

  • Ensure that mailers are sent at least 30 days prior to the Wellness Day events

  • Ensures that all documentation requirements are met per the guidance of the Manager and/or Director

  • Complies with Plan personnel policies and procedures

  • Participates in the development of departmental manuals, policies and procedures in accordance with Virginia Premier Health Plan quality improvement guidelines

  • Demonstrates excellent understanding of Premier Health Plan utilization, quality assurance and credentialing procedures

  • Other duties as assigned

  • Good Driving Record Required

Qualifications

MINIMUM EDUCATION REQUIREMENTS

  • High School Diploma required; BS highly preferred

SPECIAL KNOWLEDGE AND/OR SKILLS

  • Analytical skills – proficient using Microsoft Office including Microsoft Excel

  • Openly and actively communicates information and takes initiative to communicate extensively

  • Ability to handle difficult situations diplomatically

  • Effective interpersonal skills, collaboration, and listening skills

  • Ability to build strong relationships within and outside the health plan

  • Strong strategic and business acumen and well grounded in healthcare delivery systems

  • Negotiation skills

WORK BACKGROUND/EXPERIENCE

  • One year previous experience in a member and/or provider engagement role

  • Medicare/Medicaid experience / knowledge highly preferred

PHYSICAL REQUIREMENTS

  • Physical health sufficient to meet the ergonomic standards and demands of the position

About Us

Virginia Premier is a managed care organization which began as a full-service Medicaid MCO in 1995. Partnered with VCU Medical Systems we strive to meet the needs of the underserved and vulnerable populations in Virginia by delivering quality driven, culturally sensitive and financially viable Medicare and Medicaid healthcare programs. Headquartered in Richmond, VA we also have offices in Roanoke, Tidewater and Bristol with additional satellite locations allowing us to serve over 200,000 members across eighty counties throughout Virginia.

We offer competitive salaries and a comprehensive benefits package to include excellent Medical, Dental and Vision Plans, Tuition Assistance, Infant-At-Work Program, Remote Work options and generous vacation and sick leave policies. Our culture supports an environment where employees can continuously learn and gain professional growth through various development programs, education, exciting projects and career mobility.

All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. EOE

Our mission is to inspire healthy living within the communities we serve!

Job ID 2018-5326

As an equal opportunity employer, Virginia Premier is committed to a diverse workforce. To ensure non-discrimination and affirmative action for individuals protected by Executive Order 11246, as amended, Section 503 of the Rehabilitation Act of 1973, as amended, the Vietnam Veterans’ Readjustment Act of 1974, as amended, and Title I of the Americans with Disabilities Act of 1990, as amended, Virginia Premier will consider applicants for employment without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. Applicants who require accommodation in the job application process may contact Recruitment at 804-819-5151 for assistance. It is the policy of Virginia Premier Health Plan, Inc., to comply with the requirements of the Drug-Free Workplace Act of 1988. It is a violation of our drug-free workplace policy to use, possess, sell, trade, and/or offer for sale alcohol, illegal drugs or intoxicants in our workplace. Federal law requires all employers to verify the identity and employment eligibility of all persons hired to work in the United States. Virginia Premier participates in E-verify.