Description

Job Title: Outreach & Education Representative

Location: Hybrid

Responsible for developing and maintaining positive relations between providers to create a culture of learning and improved performance among the provider network.

Primary duties may include, but are not limited to:

• Researches and retains Medicaid regulations.

• Works with all departments to address provider technical assistance and educational issues.

• Provides education/re-education and training to providers regarding Beacon Health Options of PA and via face-to-face and web-based training platforms.

• Utilizes comprehensive knowledge of some Medicaid coverage issues, medical coding, and general knowledge of CMS and claims processing systems.

• Builds processes and tools to assist and monitor provider performance

• Owns a provider outreach program that demonstrates improvements in provider performance and experience

• Identifies and selects potential providers to participate in guided focus groups.

Minimum Qualifications:

• Requires a BA/BS and a minimum of 3 years of Managed Care and Medicaid Contract experience

Preferred Qualifications:

• Certified medical coder preferred.

• Some travel may be required.

• Strong communicator who can work with providers and stakeholders alike to drive alignment

• Superior analytic skills

• Full competence in report design
  

Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health has been named as a Fortune Great Place To Work in 2022, has been ranked for five years running as one of the 2023 World’s Most Admired Companies by Fortune magazine, and is a growing Top 20 Fortune 500 Company. To learn more about our company and apply, please visit us at careers.ElevanceHealth.com. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.