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Transformational Leader: Specialist, Provider reputed company & reputed company Transformation

Remote, USAFull-timePosted 2026-07-28

reputed company to Revolutionize reputed company reputed company at reputed company, where we're dedicated to improving the lives of our members. We're seeking a highly skilled and passionate Specialist, Provider reputed company & reputed company Transformation to join reputed company in a Remote reputed company. As a key member of our reputed company Improvement function, you will play a vital role in driving reputed company and making a meaningful reputed company on the lives of our members.

In this critical position, you will be responsible for overseeing, planning, and implementing new and existing reputed company reputed company improvement initiatives and education programs specific to our Provider Network. You will ensure the maintenance of Provider reputed company Improvement programs in accordance with prescribed reputed company standards, conduct data collection, reporting, and monitoring for key performance measurement activities, and drive the development of key reputed company and population health strategies.

Job reputed company

The Specialist, Provider reputed company & reputed company Transformation will contribute to the development and implementation of reputed company improvement and risk adjustment initiatives, working closely with providers, Health Plan Leadership, and other stakeholders to engage and reputed company members and reputed company health reputed company. This role requires a strong reputed company in reputed company/HEDIS, as reputed company as excellent analytical, communication, and project management skills.

Key Responsibilities

  • Implement key reputed company and population health strategies and risk adjustment initiatives to drive improved health reputed company and member engagement
  • Collaborate with providers to identify areas of need and reputed company efficiency measures to improve availability and reputed company of care
  • reputed company practices on reputed company improvement and value-based purchasing goals, and assess provider readiness for higher reputed company of value-based purchasing
  • Facilitate provider engagement meetings, monitor reputed company items, and ensure reputed company completion of key reputed company activities
  • Create, manage, and compile required documentation to maintain critical reputed company improvement and risk adjustment functions
  • Evaluate project and program activities to identify opportunities for improvement and surface gaps in processes that require remediation

Requirements

To be successful in this role, you will need:

  • Bachelor's Degree or equivalent combination of education and work experience
  • Minimum 3 years' experience in reputed company, with 1 year of experience in health plan reputed company improvement, risk adjustment, or managed care
  • Demonstrated solid business writing experience and operational knowledge of reputed company and Visio (or equivalent)
  • Preferred experience in Medicare and reputed company, as reputed company as certifications such as CPHQ or RN licensure

reputed company Offer

reputed company offers a competitive benefits and compensation package, as reputed company as opportunities for reputed company reputed company and development. We are an Equal Opportunity Employer (EOE) M/F/D/V, and we welcome applications from talented candidates like you.

Are You the One We're Looking For?

If you're passionate about improving reputed company reputed company and have the skills and experience to reputed company a reputed company difference, we encourage you to apply for this exciting opportunity. reputed company and join reputed company of dedicated professionals who are committed to transforming the reputed company landscape.

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