Provider Engagement Specialist - Field in Fresno County

About the role

The Provider Engagement Specialist plays a crucial role in improving network performance, enhancing provider satisfaction, and supporting organizational growth at Alignment Health. Reporting directly to the Senior Director of Provider Relations, this position works closely with provider offices to drive performance improvements and build long-term relationships.

Responsibilities

• Build and maintain collaborative relationships with providers and their staff to support growth, retention, and performance improvement.
• Partner with providers to improve performance on key performance indicators (KPIs), including but not limited to growth, retention, Annual Wellness Visits (AWVs), HEDIS gap closures, hospital and ER utilization, risk adjustment, and other quality indicators.
• Conduct initial provider onboarding and provide ongoing education on Alignment tools, clinical programs, PCP incentives, member benefits, Model of Care, compliance requirements, and organizational initiatives.
• Aid in the development of training and educational materials and tools. Create provider in-service and implementation packets.
• Facilitate and serve as a single point of resolution for provider issues, including UM, prior authorization, claims, encounter data, eligibility, provider rosters, and directory validation.
• Represent Alignment Health at provider meetings, trainings, and community events; document meeting minutes and action items as needed.
• Create weekly activity summaries and submit reports on a weekly basis.
• Attend and participate in all staff meetings as required.
• Perform special projects as assigned.

Requirements

• Minimum two years of related experience and/or training, or equivalent combination of education and experience.
• Experience in provider relations/contracting within an HMO, IPA, medical group, or institutional provider setting required.
• Bilingual (English/Spanish) preferred.
• Organized, detail-oriented, and self-starter.
• Strong analytical, quantitative, and problem-solving skills.
• Excellent verbal and written communication skills.
• Relationship-builder and team player.
• Strong presentation skills with ability to address diverse audiences effectively.
• Proficient in Microsoft Office Suite (Word, Excel, PowerPoint).
• Ability to travel 80% or more by car routinely in assigned market; occasional air travel as needed.
• Maintenance of reliable transportation, valid driver’s license, and automobile insurance required.
• Flexibility to work extended hours as needed.
• Remote work available upon approval.

Other Requirements

• B.A./B.S. degree preferred or two years relevant experience.
• Experience in provider relations/contracting within an HMO, IPA, medical group, or institutional provider setting required.
• Bilingual (English/Spanish) preferred.
• Organized, detail-oriented, and self-starter.
• Strong analytical, quantitative, and problem-solving skills.
• Excellent verbal and written communication skills.
• Relationship-builder and team player.
• Strong presentation skills with ability to address diverse audiences effectively.
• Proficient in Microsoft Office Suite (Word, Excel, PowerPoint).
• Ability to travel 80% or more by car routinely in assigned market; occasional air travel as needed.
• Maintenance of reliable transportation, valid driver’s license, and automobile insurance required.
• Flexibility to work extended hours as needed.
• Remote work available upon approval.

Pay

$58,531.00 - $87,797.00 per year

Schedule

Full-time