Provider Engagement Consultant

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Blue Cross and Blue Shield of Vermont is looking for a Provider Engagement Consultant to join our Risk Adjustment team. Our company culture is built on an unwavering focus on our members and giving them the best service possible. We offer a balanced, flexible workplace, an onsite gym, fitness and wellness programs, a competitive salary and full benefits package including medical and dental insurance, vision, 401k, paid time off and holidays, tuition reimbursement and student loan repayment, dependent caregiver benefits, and resources to support your ongoing personal and professional growth and development.

COMPENSATION: The base salary range for this position is $67,000-75,000. Additional compensation opportunities and incentives will be detailed during the interview process. Please note that the range listed above is our good faith estimate of the hiring range for this role. If you are hired at Blue Cross and Blue Shield of Vermont, your final base salary compensation will be determined based on factors such as skills, competencies, education, experience, and internal equity across the current team. We also offer a robust benefits package with significant value (see below).

LOCATION: Blue Cross has transitioned to a hybrid workplace where employees within driving distance of our Berlin, VT office work Wednesdays in the office with flexibility to work remotely the rest of the week. This position requires on-site attendance on Wednesdays.

Provider Engagement Consultant Responsibilities:

• Serve as the primary point of contact, consultative resource and subject matter expert for providers as it relates to Qualified Health Plan (QHP) Risk Adjustment
• Educate practitioners and office staff on processes related to Risk Adjustment and best practices.
• Meet regularly with internal and external stakeholders and leaders to review provider performance and formulate tactics to facilitate continuous improvement
• Educate practices on accurately depicting a member's health status through accurate documentation and coding at the provider level to ensure that the Blue Cross plan's risk score is as accurate as possible
• Share gap reports with provider offices and internal partners as necessary
• Use existing resources to collaborate with provider offices and internal partners on gap closure barriers as well as best practices for documentation and coding.
• Work closely with provider groups and their staff to close gaps and assist in having members seen in offices yearly.
• Work primarily through personal contact with the provider community and travels up to 25% of the time

Provider Engagement Consultant Qualifications:

• Bachelor's degree, or equivalent combination of education and experience.
• Two or more years of clinical practice experience in a provider's office, hospital setting, health plan or comparable environment required, preferably with experience in provider engagement/performance programs.
• Direct experience working with providers and/or in a provider's office
• Advanced oral, verbal, written, and presentation skills and a strong presence or in person, online and telephone engagement. Advanced ability to read and comprehend clinical text found in medical records with attention and appreciation for detail.
• Experience with clinical documentation and/or formal coding certification from American Academy of Professional Coders (AAPC) or American Health Information Medical Association (AHIMA) strongly preferred.

Provider Engagement Consultant Benefits:

• Health insurance (including vision)
• Dental coverage (free to employees)
• Wellness Program
• 401(k) with employer match + automatic employer contribution
• Life Insurance
• Disability Insurance
• Combined time off (CTO) - 20 days per year + 10 paid holidays
• Tuition Reimbursement
• Student Loan Repayment
• Dependent Caregiver Benefits

Diversity, Equity, and Inclusion: Blue Cross VT is committed to creating an inclusive environment where employees respect, appreciate, and value individual differences, both among ourselves and in our communities. We welcome applicants from all backgrounds and experiences to join us in our commitment to the health of Vermonters, outstanding member experiences, and responsible cost management for all the people whose lives we touch. Learn more about our DE&I commitment at http://www.bluecrossvt.org/about/diversity-equity-and-inclusion.

• Full job description attached to ADP job posting.