Provider Engagement & Experience Director (Flexible NC Location) Position Available In Mecklenburg, North Carolina

Provider Engagement & Experience Director (Flexible NC Location) 3.9 3.9 out of 5 stars Davidson, NC 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:

Flexible for any of Partners’ NC locations

Closing Date:

Open Until Filled Primary Purpose of Position:

The Director of Provider Engagement and Experience represents the scope of Partners’ Health Plan and provider relationship across such areas as financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation and coding, HEDIS and STARs performance, as indicated, operational improvements and other areas as they relate to provider performance, member experience, market growth, provider experience and operational excellence. The Director of Provider Engagement and Experience works strategically with the providers and physicians with the purpose and aim of building a partnership with providers to actively participate in quality improvement initiatives and value-based care models. Provider engagement involves deeper communication and collaboration with providers, often including data sharing, educational programs, and feedback loops to align goals and improve care delivery. Develops and implements initiatives and projects supporting provider engagement and quality improvements support. Supports robust provider engagement to achieve positive operational and financial outcomes.

Role and Responsibilities:

Work with the Sr. Director of Provider Network and the Provider Network Leadership Team to build out clinical education sessions for providers on guidelines created by the health plan. To successfully implement the sharing of patient data analytics to identify areas for quality improvement as a useful resource for providers to ensure success in the Partners’ provider network and support of the Provider Support Plan. Supports Physical Health Provider Education in conducting new provider onboarding and training to familiarize providers with working with Partners and meeting contractual obligations and compliance. Works to ensure excellent inter-department communications for key coordination activities to ensure network performance. Maintain and build strong business relationships with Providers and champion their requests to ensure a positive Provider experience and instill confidence in the Partners’ brand. Works collaboratively with the Population Health and Quality Management Departments to implement incentive programs based on quality metrics. Conducting regular provider satisfaction surveys to understand physician needs and concerns. Works to ensure successful implementation through cross functional collaboration of the provider support plan. The Director of Provider Engagement and Experience will understand, commit to and embed the principles of equity, effectiveness, and efficiency into every facet of the provider/physician engagement to educate physicians on understanding the benefits of improved healthcare and ensuring their understanding of the equitable distribution across all societal segments. Embracing this comprehensive framework addresses immediate healthcare challenges and paves the way for a future where every individual, regardless of their circumstances, has access to high-quality healthcare. Works effectively with the Provider Network Director of Operations and Provider Network Relations Director to ensure successful NCQA Accreditation and compliance towards contractual requirements. Leads a team of Provider Engagement staff (PES) working with Strategic Providers to improve Quality outcomes. Works with the Sr. Director of Provider Network to establish the strategy and operational direction for all Provider Engagement activities in collaboration with the Provider Network Leaders, Senior Leadership and Executive Leadership. Coordinates and facilitates PES team meetings, including meeting agendas, minutes, handouts, and monitoring action items to completion. Ensures health plan stakeholders are engaged and prepared to report quarterly updates at the meetings and overall, to health plan Senior Leadership Team meetings. May lead one or more teams from multiple disciplines (Quality, Provider Services, Clinical, Operations) to engage with key providers. Ensures that there is content, maintenance and tracking of all Provider Engagement Staff activities and regularly collects, monitors and disseminates reporting to Provider Engagement Staff. Builds internal relationships to develop a TEAM approach to Provider Engagement. Builds and nurtures positive relationships between strategic providers and Plan. Reports on Strategic Provider results (e.g. changes in Quality outcomes, financial results, etc.) on a periodic basis to Sr. Provider Network Director and other groups as requested. Perform provider orientations and ongoing provider education, including writing and updating orientation materials and provider materials. Manages Network performance for the plan through a consultative/account management approach Evaluates provider performance and develops strategic plan to improve performance Drives provider performance improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS/quality, cost and utilization, etc. Completes special projects as assigned Performs other duties as assigned Complies with all policies and standards

Knowledge, Skills and Abilities:

Comprehensive knowledge of mental health, substance use and intellectual and developmental disabilities and service delivery systems for the entire spectrum of client categories including an understanding of principles, concepts and Best Practices used in the treatment, habilitation, and support of individuals with needs in any of the disability areas Comprehensive knowledge of Partners Strategic Plan, Quality Management Plan, Provider Support Plan. Comprehensive Knowledge of Physical Health Practice supports, HEDIS Measures, closing care gaps and practice communication. Must have knowledge of Medicaid Transformation and Managed Care Knowledge of the laws, regulations and programs impacting mentally ill, substance abusing and intellectually and developmentally disabled clients and their families Must understand LME/MCO goals, targets, and outcomes in relation to the responsibilities and supporting relationships of the Network Management Department A high level of diplomacy and discretion is required to effectively negotiate and resolve issues with minimal assistance, requiring exceptional interpersonal skills, teambuilding skills, highly effective communication ability, and the propensity to make prompt independent decisions based upon relevant facts Problem solving, negotiation, arbitration, and conflict resolution skills are essential to balance the needs of both internal and external customers Requires public speaking and mediation skills to facilitate collaboration and positive relationships between teams, families/consumers, and agencies Excellent computer skills including proficiency in Microsoft Office products (such as Word, Excel, Outlook, PowerPoint) Ability to review and analyze data to evaluate program effectiveness, progress, problems, and system performance Ability to establish and maintain positive and effective working relationships with leadership and staff, stakeholders, and local/state/federal officials Managed care knowledge of data systems, database management, provider networks, claims payment and/or clinical services. Managed healthcare industry knowledge and including management of complex, interdependent functions. This position requires an individual to be extremely organized, have a keen attention to detail and the flexibility to work with different aspects of a business. Must have management and supervisory skills, communication, organization and staffing skills as well as a strong financial and budgeting acumen. Strong verbal and written communication skills are important in this position to work well with a variety of employees and sometimes with clients and outside vendors Proven ability to plan, organize, schedule, direct, control, and monitor large-scale, multi-functional project activities. Willingness to establish and maintain effective working relationships with others as a team by offering support and/or ideas to enable staff to reach goals. Visionary Leadership

• Displays passion and optimism; Inspires respect and trust; Mobilizes others to fulfill the vision; Provides vision and inspiration to peers and subordinates. Change Management
• Develops workable implementation plans; Communicates changes effectively; Builds commitment and overcomes resistance; Prepares and supports those affected by change; Monitors transition and evaluates results. Leadership
• Exhibits confidence in self and others; Inspires and motivates others to perform well; Effectively influences actions and opinions of others; Accepts feedback from others. Managing People
• Includes staff in planning, decision-making, facilitating and process improvement; Takes responsibility for subordinates’ activities; Makes self-available to staff; Provides regular performance feedback; Develops subordinates’ skills and encourages growth; Solicits and applies customer feedback (internal and external); Fosters quality focus in others.

Quality Management/Quality Improvement approach

• Looks for ways to improve and promote quality; Demonstrates accuracy and thoroughness.

Improves processes, products, and services. Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies Demonstrated ability to manage multiple projects and meet deadlines Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Education/Experience Required:

Bachelor’s Degree in mental health, public health, social work, psychology, education, sociology, business, or public administration and five (5) years of experience in a community, business, or governmental program in health-related fields, social work or education. At least five (5) years’ experience in physical health network operations, network management, provider relations and management experience, and/or health care managed care physical health provider contracting. Three (3) three years of supervisory, consultative, or administrative experience. A combination of relevant experience may be considered in lieu of a bachelor’s degree. NC Residency is required.

Education/Experience Preferred:

Master’s Degree in mental health, public health, social work, psychology, education, sociology, business, or public administration and five (5) years of experience in a community, business, or governmental program in health-related fields, social work or education including experience in network operations, provider relations and management experience. Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses and quality/bonus performance.

Licensure/Certification Requirements:

None