Provider Performance Specialist II

  • location: East Syracuse, NY
  • type: Permanent
  • salary: $50,000 - $60,000 per year

job description

Provider Performance Specialist II

Are you a friendly and motivated individual who loves working in a fast paced environment? If so, we are looking for a multifaceted individual who can successfully multi-task the day to day responsibilities of a Provider Relations Specilist II. We are looking for someone who is comfortable on the phone, has great computer skills, is organized with the ability to multitask in a busy enviorment.  

Responsibilities

Interpret performance data, prioritizing insights and developing discussion and presentation documents, including year-to-date results, month-over-month performance, and member engagement results

Facilitate provider discussions regarding quality, utilization, and cost or risk performance improvement opportunities, utilizing corporate tools and reporting

Collaborate with health plan quality counterpart to ensure coordinated communication and goal alignment for provider discussions

Develop proficiency in tools and value based performance (VBP) and educate providers on the use of tools and interpretation of data

Present detailed HBR (Health Benefits Ratio) analysis and create reports for Joint Operating Committee meetings 



Provide consultative support to providers to improve their performance on member outreach, utilization management, cost, quality and risk. Discuss, analyze and interpret performance reporting, member engagement data and other data resources to identify opportunities. 





Skills

  • Written Communication
  • Decision Making
  • Working Independently
  • Benefits Administration
  • Problem Solving
  • Customer Service
  • Answering Phones
  • Multi-tasking
  • Handling Confidential Information
Education
  • High School (required)
Qualifications
  • Years of experience: 2 years
  • Experience level:Experienced
Shift: First

Working hours: 8 AM - 5 PM

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

EEO Employer: Race, Religion, Color, National Origin, Citizenship, Sex, Sexual Orientation, Gender Identity, Age, Disability, Ancestry, Veteran Status, Genetic Information, Service in the Uniformed Services or any other classification protected by law.

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