Primary City/State:

Arizona, Arizona

Department Name:

Network Development

Work Shift:

Day

Job Category:

General Operations

A rewarding career that fits your life. As an employer of the future, we are proud to offer our team members many career and lifestyle choices including remote & hybrid work options. If you’re looking to leverage your abilities – you belong at Banner.

Banner Plans & Networks (BPN) is an integrated network for Medicare and private health plans. Known nationally as an innovative leader, BPN insurance plans and physicians work collaboratively to keep members in optimal health while reducing costs. Supporting our members and vast network of providers is a team of professionals known for innovation, collaboration, and teamwork. If you would like to contribute to this leading-edge work, we invite you to bring your experience and skills to BPN.

In the role of a Care Transformation Specialist, you will leverage your expertise in health plans, insurance, Medicare, Medicare STARS ratings, HEDIS, and Medicaid to guide and assist providers and their office staff. Your designated territory will encompass practices in Southern Arizona, which you will engage with through email, phone, and direct visits.

The primary work schedule is Monday through Friday during Arizona business hours. Flexibility in days and hours is necessary to accommodate the practices' needs. The position is a remote hybrid, involving work from a home office and on-site at assigned practices. Residency in Central or Southern Arizona is required for this role. Interested candidates are encouraged to apply today!

Banner Health Network (BHN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. Through BHN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs.

POSITION SUMMARY

This position is responsible for the communication and education of projects and initiatives to the provider network and will be responsible for knowing and understanding a wide breadth of information across the health system. This position will build and maintain relationships, ensuring that the provider networks’ needs are met and supported through all of their business interactions with the Insurance Division.  This role will support the growth of lives to Banner Health Network and the value based care initiatives by the company. 

CORE FUNCTIONS

1. Serves as the primary relationship point for the designated office/territory. Responsible for communicating health plan initiatives and education. Engages office physicians and staff, building rapport, relationships and engagement. Responsible for all outbound physician/office communication. Manages office relationship, contract requests and contract expansion for adding lives and increasing lines of business/lives to grow health plans.

2. Builds and supports effective relationships with internal and external stakeholders and organizations. Develops partnerships, coordinates activities, reviews work, exchanges information, and/or resolves problems related to facility, regional, and system programs.

3. Collaborates and leverages resources and capabilities across multi-disciplinary teams. Creates a collaborative environment despite ambiguity and uncertainty in the various stages, providing tools and resources to address the needs of teams and work groups.

4. Gather data from various multi-disciplinary teams and provides the necessary information to support improvement efforts. Ensures development and compliance with operating and capital budgets and achievement of financial performance.

5. Provides coordination and oversight of implementation of improvements with leadership, facility administration, and physician stakeholders.

6. Travels frequently to physicians’ offices doing site visits, educating office staff and resolving established problems.

7. Reviews analysis and reports of various activities to measure progress toward stated goals and objectives.

8. Implements operational and/or specific process improvement work addressing clinical and operational performance. Provides conclusions and recommendations to company leadership. Partners with facility/entity departments, physician stakeholders, and other entities within the system as appropriate to achieve defined goals.  Establishes and promotes teamwork and collaboration between individuals, departments, and providers in the development of improvement initiatives and targets. Must maintain effective communication with various stakeholders and ensure timely, accurate and efficient reporting of operational details to drive timelines and deliverables. The incumbent will work independently under general supervision and must exercise sound judgment and decision-making within generally defined practices and policies. Position will interact with all levels of Banner leadership and personnel, Regulatory and outside agencies, and outside organizations and vendors.

MINIMUM QUALIFICATIONS

Bachelor’s Degree in business, healthcare related field or equivalent experience. 

One to two years experience in clinical care or a role supporting clinical or provider operations.

Adept at creating and communicating a clear and detailed program plan to internal/external stakeholders, effectively aligning resources and motivating multi-disciplinary teams to achieve goals and create partnership-style relationships. Demonstrated technical, organizational, project management and negotiation capabilities. Must be a self-starter with excellent ability to implement and execute. Ability to balance the big picture with the day-to-day delivery details, connecting key project needs and internal resources to prioritize the workload. Strong desire to improve the lives of patients, their care givers, and families. Possesses compassion and empathy coupled with accountability and execution.

Requires proficiency in the use of sophisticated software programs.

PREFERRED QUALIFICATIONS

Clinical background with current license/certification or equivalent experience.

Additional related education and/or experience preferred.

NCQA, STARS Measures, HEDIS, Value Based Purchasing, and Project Management experience highly preferred.

EEO Statement:

EEO/Female/Minority/Disability/Veterans

Our organization supports a drug-free work environment.

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