This job was posted by https://idahoworks.gov : For more information,please see: https://idahoworks.gov/jobs/2154047 The Provider EngagementSpecialist promotes, contributes, and grows provider relationships byproviding education, engagement, and/or outreach activities. Promotesand enhances relationships with providers to invest in the health ofmembers. Responsible for the overall performance of assigned practiceswithin risk adjustment programs.

　　The Specialist will have flexibility to work onsite in our MeridianIdaho campus and/or hybrid location (onsite Meridian Idaho +work-from-home); it may potentially have ability to work fully remotefrom a mutually acceptable location within Idaho or contiguous area toIdaho. #LI-Remote; #LI-Hybrid

　　Required Education: Bachelor\'s Degree or equivalent work experience(Two years\' relevant work experience is equivalent to one-year college)

　　Required Licenses/Certifications:

　　Must hold: Certified Professional Coder Certification (CPC) orClinical Certification (MA or above)Certified Risk Coder Certification, or must obtain within one yearof date of hireTravel: Typically (1) week a month, (9) months of the year, toclinic offices within the Specialist\'s assigned region. Effort is madeto align travel region to the Specialist\'s general location. Fullyremote team members will be required to visit onsite at BCI\'s maincampus in Meridian Idaho (one week per quarter).

　　Required Experience: at Specialist I, must have 2/+ years\' providerservice, coding, or health industry experience; Specialist II requires 4years.

　　Your day may look like:

　　Develops content and conducts training to assigned practices.Influences, develops, and maintains provider education materialsrelated to risk adjustment.Manages and coordinates the creation, distribution and collection ofclinical documentation and coding improvement tools.Analyzes and interprets provider risk adjustment performancereports. Develops and implements plans to meet target performancemetrics.Interprets and maintains current risk adjustment regulatory rulesand guidelines to ensure compliance standards are maintained withininternal policies, procedures, and workflows.Analyzes reporting or provider education programs to identifyopportunities for education and/or enhanced reporting.Identifies and leads performance improvement projects that maximizeprovider value-based reimbursements.Performs risk adjustment medical record reviews as a primary coderand communicates findings to providers.Specialist II may also:

　　Develops and implements strategies for implementation of annual CMSproposed process changes and updates related to regulatory riskadjustment requirementsDevelops and maintains cross-functional business relationships withinternal and external partnersDrives provider-related process improvementsIdentifies strategic opportunities within department\'s riskadjustment processesConducts quality oversight of risk adjustment medical reviews toidentify, validate and review errors found during chart audits,including RADVsReasonable accommodations

　　To perform this job successfully, an individual must be able to performeach essential duty satisfactorily. The requirements listed above arerepresentative of the knowledge, skill and/or ability required.Reasonable accommodations may be made to enable individuals withdisabilities to perform the essential functions.

　　We are an Equal Opportunity Employer and do not discriminate againstany employee or applicant for employment because of race, color, sex,age, national origin, religion, sexual orientation, gender identity,status as a veteran, and basis of disability or any other federal, stateor local protected class.