Company Statement

For the last 80 years, EmblemHealth has been taking care of New York’s heart and soul, its people. Today, health care is more complex than ever. That’s why we’re at the forefront of change. We work alongside our customers to offer access to high-quality, affordable care, help navigate the health care experience, and make good health achievable; because everyone deserves to be taken care of. We deliver on our mission every day by living our values with our colleagues, members, clients and partners. It begins with caring and respecting all those we work with. We believe a culture of diversity and inclusion is vital to serve our unique and diverse customers. We seek for continues improvement and innovation and believe being agile and nimble is our advantage. We bring a strong sense of partnership to every relationship – internally and externally. The EmblemHealth family of companies offers competitive health, welfare, and retirement benefits as well as incentive pay plans and more.

Provider Education & Engagement Specialist

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Manager & Professional
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2008Z Requisition #
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Responsible for ensuring the ongoing regulatory and contractual compliance for CMS, DOH and ASO Clients of the special populations education requirements for FIDA and SNP MOC providers in the VIP Prime and Medicare Essential Networks.  Will be responsible for implementation and oversight of the creation, hosting, tracking and reporting on delivery of required Special Populations, “Competencies” and ADA Compliance modules.  Will audit functioning of modules and keep content current and accurate.  Lead FIDA engagement activities and manage % completion.  Will develop and monitor reports on provider education status.  Vendor management.  Will be responsible for data file exchanges.  Will be responsible to UAT plan development and execution for education delivery and eSAWs programming.  Develop targeted programs that reach non-compliant physicians to produce results.

Responsibilities:
  • Education Compliance
    • Will monitor reports and make recommendations based on findings
    • Will keep business partners updated on status of trainings/attestations
    • Will create strategic action plans for provider compliance with training requirements
    • Will be responsible for outreach to non-compliant providers needed for ITDs
    • Will coordinate with PNM staff to promote training
    • Will coordinate communications re: training opportunities and requirements
    • Will act as FIDA departmental Lead for PCM
  • Education Module Development
    • Will be responsible for on-boarding  and education decks for forums, webinars and  self-serve online presentations – keeping content current and accurate – managing through JetPAC Process
    • Will work with Marketing  & Communications to add self-serve presentations to provider manual to support web use and  electronic communication with Care Mgt staff
    • Will create education modules to address issues that drive high frequency of calls and Message Center inquiries
    • Will partner with Customer Service, QI, NCQA and Care Management to address education needs to support success of program in addition to required training modules
  • Speaker Management
    • Engage community-based organizations to provide education sessions regarding their organization’s resources. For example, the Alzheimer’s Association has offered speakers to present at scheduled workshops.  Will support CMS and DOH expectation regarding plan’s coordination with community-based organizations as well as promotion of Culturally Competent care
  • Provider Manual Content
    • Work with SMEs and ASO clients to develop required content for the provider manual
Qualifications:
  • Bachelors degree required
  • Minimum of 3 to 5 years experience writing for the web and supporting web-based education programs required
  • Strong project management skills, with attention to detail on dozens of complex, simultaneous, high visibility, dead lined projects, to assure meeting deadlines and producing accurate materials required
  • Experience working in the health care industry required
  • Experience writing contracts/amendments and implementing regulatory requirements required
  • Professional editorial judgment and writing skills, to control quality and accuracy of materials produced as well as support general communications editorial services required
  • Proven interpersonal and communication skills, to negotiate cooperation and resolve differences across hierarchical lines as well as to keep multiple players fully informed required
  • Ability to create detailed program plans, using project planning software as necessary, to provide multiple resources with the master plans they need to understand responsibilities and interim as well as final deadlines required
  • Understanding of Plan’s systems, products and operations required

EEOC Statement

We are committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our people and our business. We are an equal opportunity/affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law.

Sponsorship Statement

Depending on factors such as business unit requirements, the nature of the position, cost and applicable laws and regulations, EmblemHealth may provide work visa sponsorship for certain positions.

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