The Sr. Provider Specialist in this role must be Certified Diabetes Care and Education Specialist ( CDCES ) . This role provides expert diabetes care, management, and education for Priority Health. An ideal candidate will have knowledge of healthcare plans. They will also be detail oriented, self-motivated and haveMicrosoft Office experience.Under general direction, is a liaison for health plan initiatives with physician hospital organizations (PHO), physician organizations (PO) state-wide and community entities. Partners with internal teams to develop and implement strategic initiatives. Manages and coordinates large multi-faceted projects in an organized and cost effective manner.Essential Functions
Partner with internal teams and/or serve as a network/community liaison for strategic initiatives, training and Programs. This may include the assessment, analysis, planning, implementation and evaluation of multiple interventions, programs and data in support of Network efficiency, health outcomes and patient experience.
Identifies, monitors, coordinates and manages multiple projects. This includes project scope, targets, timelines, resource requirements/costs, milestones and data requirements. Creates and prepares accompanying documents and reports.
Coordinates the implementation of clinical pilots to ensure practice commitment to program goals and deadlines. Monitors results of pilot programs to ensure objective are achieved.
Responsible for the analysis, review and dissemination of network performance information, including but not limited to financial, quality, utilization/satisfaction and/or disease specific.
Develops and delivers or facilitates effective multi-media communication strategies, meetings, trainings and education materials for presentations with a variety of internal and external audiences.
Serves as subject matter expert and resource for researching industry practices, sharing best practice and market surveillance information to internal and external customers.
Certified Diabetes Care and Education Specialist ( CDCES )
Qualifications
Required Bachelor's Degree
Preferred Master's Degree
5 years of relevant experience in health plan, managed care or healthcare delivery, administration or clinical practice management. Required
Knowledge of Facets Cactus, Health Information Technology and Business Objects. Preferred
Knowledge of Health and Population Technology and Provider reporting. Preferred
Certified Diabetes Care and Education certification required
Proficient with Microsoft Office, PowerPoint and Excel
GuidingCare software experience preferred
RN License preferred
Physical Demands
Pallet to Waist (6" from floor) > 5 lbs: Seldom up to 10 lbs
Waist to Waist > 5 lbs: Seldom up to 10 lbs
Waist to Chest (below shoulder) > 5 lbs: Seldom up to 10 lbs
Waist to Overhead > 5 lbs: Seldom up to 10 lbs
Bilateral Carry > 5 lbs: Seldom up to 10 lbs
Unilateral Carry > 5 lbs: Seldom up to 10 lbs
Pushing Force > 5 lbs: Seldom up to 10 lbs
Pulling Force > 5 lbs: Seldom up to 10 lbs
Sitting: Frequently
Standing: Occasionally
Walking: Occasionally
Forward Bend - Standing: Seldom
Forward Bend - Sitting: Occasionally
Trunk Rotation - Standing: Seldom
Trunk Rotation - Sitting: Occasionally
Reach - Above Shoulder: Seldom
Reach - at Shoulder or Below: Seldom
Handling: Occasionally
Forceful Grip > 5 lbs: Seldom
Forceful Pinch > 2 lbs: Seldom
Finger/Hand Dexterity: Frequently
Primary LocationSITE - Priority Health - 1231 E Beltline - Grand RapidsDepartment NamePH - Care Management - CommercialEmployment TypeFull timeShiftDay (United States of America)Weekly Scheduled Hours40Hours of Work8 a.m. to 5 p.m.Days WorkedMonday to FridayWeekend FrequencyN/ACURRENT COREWELL HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only. Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.You may request assistance in completing the application process by calling 616.486.7447.People are at the heart of everything we do, and the inspiration for our legacy of outstanding outcomes, innovation, strong community partnerships, philanthropy and transparency. Corewell Health is a not-for-profit health system that provides health care and coverage with an exceptional team of 60,000+ dedicated people—including more than 11,500 physicians and advanced practice providers and more than 15,000 nurses providing care and services in 22 hospitals, 300+ outpatient locations and several post-acute facilities—and Priority Health, a provider-sponsored health plan serving more than 1.2 million members. Through experience and collaboration, we are reimagining a better, more equitable model of health and wellness.