Job Details

Competitive Compensation & Benefits Package!
Position eligible for -

• Annual incentive bonus plan
• Medical, dental, and vision insurance with low deductible/low cost health plan
• Generous vacation and sick time accrual
• 12 paid holidays
• State Retirement (pension plan)
• 401(k) Plan with employer match
• Company paid life and disability insurance
• Wellness Programs
• Public Service Loan Forgiveness Qualifying Employer

See attachment for additional details.

Office Location: Available for any of Partners locations; Remote Option

Projected Hiring Range: Depending on Experience

Closing Date: Open Until Filled

Primary Purpose of Position: The Cross-Functional Provider Engagement & Outreach Specialist serves as a liaison between Partners Health Management and healthcare/physical health providers to drive quality improvement, practice transformation, and provider engagement. This role supports physical health providers in implementing evidence-based workflows, optimizing care delivery models, and aligning with value-based care initiatives. The Specialist also leads outreach efforts to foster collaborative relationships, deliver educational resources, and support providers in meeting performance and compliance with benchmarks. This role serves as a co-supporter of provider education, training, and development in support of quality, performance, and strategic initiatives.

Roles and Responsibilities:

• Support medical providers in transforming care delivery through implementation of patient-centered medical home (PCMH), value-based care models, and quality improvement initiatives.
• Engage directly with providers and healthcare teams across North Carolina to build strong partnerships, understand their unique challenges, and provide tailored assistance
• Conduct on-site and virtual practice visits to assess workflows, identify improvement opportunities, and provide technical assistance and resources.
• Analyze and utilize performance data (e.g., HEDIS, Medicaid measures) to collaborate with providers to design targeted interventions that improve care quality and patient outcomes.
• Assist practices with change management strategies to enhance patient outcomes and operational efficiency
• Act as a liaison n supporting providers in adopting value-based care practices, that enhance clinical efficiency and patient outcomes
• Develop and disseminate outreach materials, toolkits, and communication strategies to strengthen provider relationships.
• Stay abreast of emerging best practices, payer requirements, and regulatory changes affecting provider performance and transformation.
• Deliver training and coaching on practice transformation topics, data use, and workflow redesign
• Track provider progress, document interactions, and report outcomes and barriers to leadership for continuous program improvement.
• Workdirectly with physicians, clinical teams, and administrative staff to improve care delivery, enhance patient outcomes, and increase performance.
• Collaborate with internal stakeholders to align resources and interventions
• Support practice transformation initiatives that drive sustained improvements in care quality and operational efficiency
• Work with providers to encourage preventive service utilization and effective chronic condition management among their patient populations
• Assist clinicians achieve measurable improvements in health outcomes and patient satisfaction by fostering patient engagement and adherence to recommended care plans
• In collaboration with, and under the supervision of the Provider Training, Education, and Engagement Specialist, this role will:
  • Serve as a primary liaison between internal departments and external organizations to plan, schedule, and execute approved training and provider engagement events.
  • Co-manage and maintain PN Department training repository, including the development and upkeep of the training modules, plans, reports, staff communications, and content revisions, troubleshooting, and provider support.
  • Support the co-devolvement and implementation of provider and partners training programs, including training plans, presentations, communications, postings, scheduling, and facilitation, in partnership with the Provider Engagement Training Specialist
  • Interface with learning and collaboration technology platforms to create, host, or co-host trainings and collaboratives; manage and promote sessions, monitor participation, and analyze and report training related data

Knowledge, Skills and Abilities:

• Deep understanding of value-based care models, and healthcare quality programs.
• Experience in healthcare practice transformation, care delivery redesign or clinical operations
• Experience engaging and coaching clinical teams (physicians, nurses, and practice managers)
• Familiarity with health equity initiatives and strategies to address social drivers of health.
• Experience in Project Management and familiarity in process mapping and workflow analysis tools.
• Knowledge of and ability to explain and apply the provisions of contractual practices adopted by Partners Health Management and required by NC Division of Health Benefits.
• Demonstrate working knowledge of HEDIS quality measures and reporting requirements to support accurate provider education and engagement
• Collaborate with providers and internal teams to close care gaps and ensure compliance with HEDIS and other quality initiatives.
• Experience working with large multi-site practices.
• Ability to analyze clinical and operational data to drive improvement initiatives.
• Excellent facilitation and project management skills and familiarity in process mapping and workflow analysis tools.
• Strong problem solving, decision-making and negotiating skills.
• Exceptional interpersonal skills and strong written and verbal communication skills.
• Excellent organizational skills.
• Ability to multi-task and meet deadlines.
• Considerable knowledge of the laws, regulations and policies that govern the program, which includes and is not limited to, contractual requirements adopted by NC Division of Health Benefits and other governmental oversight agencies.
• Strong problem solving, negotiation, arbitration, and conflict resolution skills.
• Excellent computer skills and proficiency in Microsoft Office products (such as Word, Excel, Outlook, and PowerPoint.
• Demonstrated ability to verify documents for accuracy and completeness; to understand and apply laws, rules and regulations to various situations; to apply regulations and policies for maintenance of consumer medical records, personnel records, and facility licensure requirements.
• Ability to make prompt independent decisions based upon relevant facts.
• Ability to establish rapport and maintain effective working relationships.
• Ability to act with tact and diplomacy in all situations.
• Ability to maintain strict confidentiality in all areas of work.
• Experience with Electronic Health Records (HER) for clinical processes
• Ability to rack, monitory, and report training participation, completion, and evaluation data
• Ability to support provider training in healthcare, Medicaid, or value-base care environments
• Ability to support virtual collaboratives or large-scale trainings

Education and Experience Required: Bachelor's degree and a minimum of four years of experience in managed care or a related field with a healthcare provider or insurer/payer. Relevant areas may include provider relations, network development or design, provider engagement services, contract management, or patient financial services. Experience in auditing, accounting, or finance is also applicable.

A combination of relevant education and experience may be considered in lieu of a Bachelor's degree. Four to six years of significant and relevant work experience in medical practice management may be accepted in lieu of educational requirements, particularly with significant administrative experience in a clinic setting.

Must have the ability to travel as indicated.

Other requirements: Must reside in North Carolina or within 40 miles of the NC border.

Education and Experience Preferred: Bachelor's degree in Nursing, Public Health, Healthcare Administration, or a related field (Master's degree preferred). Deep understanding of value-based care models, healthcare quality programs, and population health initiatives. Demonstrated experience in practice transformation roles and practice support.

Licensure/Certification Requirements: N/A