Remote Provider Engagement Specialist (North Carolina)

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

Key Responsibilities

• Build and maintain collaborative relationships with providers, office staff, and key stakeholders to support network growth and performance

• Conduct provider onboarding, orientations, and ongoing education initiatives

• Perform regular in-person provider visits to review performance metrics and identify improvement opportunities

• Analyze provider performance data and deliver actionable insights to optimize outcomes

• Educate providers on HEDIS, Stars, Risk Adjustment, and documentation/coding requirements

• Develop and implement provider engagement strategies to improve quality scores and member experience

• Support resolution of provider issues related to access, claims, eligibility, and utilization management

• Create and deliver training materials, in-service presentations, and Model of Care trainings

• Maintain accurate provider data and activity tracking in Salesforce and internal systems

• Support provider recruitment, contracting, and credentialing processes

• Negotiate and implement provider agreements in assigned markets

• Track recruitment and contracting activity and provide regular reporting

• Serve as a primary point of contact for provider inquiries, ensuring timely resolution

• Participate in team meetings and contribute to special projects as needed

• Exercise independent judgment and decision-making on complex issues with minimal supervision

Experience

• Required: Minimum 1 year of experience in provider relations, contracting, or network management within an HMO, IPA, medical group, or healthcare organization

• Preferred: 2+ years of provider-facing experience, including Medicare lines of business

• Strong understanding of HEDIS, Stars, Risk Adjustment, and MLR

Education

• Required: High School Diploma or GED (Bachelor’s degree or equivalent experience preferred)

• Preferred: MBA

Skills & Competencies

• Strong communication and relationship-building skills

• Ability to present complex healthcare topics to providers

• Proficiency in Microsoft Office (Word, Excel, PowerPoint)

• Strong analytical, problem-solving, and organizational skills

• Ability to manage multiple priorities in a fast-paced environment

• Experience analyzing and interpreting performance data and reports

Licensure & Requirements

• Valid driver’s license required

• Reliable transportation and current automobile insurance required

Work Environment & Travel

• Up to 80% travel by car within the assigned market

• Occasional air travel as needed

• Ability to work extended hours when necessary

• Remote work available with approval

Physical Requirements

• Regularly required to sit, stand, walk, and use hands for tasks

• Ability to lift up to 10 pounds occasionally

• Close vision and focus adjustment required

Additional Information

Alignment Healthcare is proud to be an Equal Employment Opportunity and Affirmative Action employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [email protected].