Prov Outreach Ed Rep I

* Position is Eligible for Remote / Work from Home Opportunity*

Department: Provider Education

Telecommuting Eligible: Yes

Job Grade: N14

As a condition of employment, physical work location must be in one of the 50 states or the District of Columbia.

Provider Outreach and Education Representative I

Job Summary

The Provider Outreach and Education (POE) Representative is responsible for delivering Federal and State-aligned, data-driven education to providers and suppliers to reduce error rates, repeat provider inquiries, and claim submission errors. The role develops compliant education materials, analyzing operational data to identify risk and error trends, and coordinating education activities across internal and external stakeholders to improve provider understanding and reduce operational burden.

Essential Functions

Key Duties/Responsibilities/Accountabilities

• Educates and facilitates provider education through webinars, teleconferences, in-person meetings, and workgroups as a subject matter expert aligned with Federal and State priorities to reduce repeat provider inquiries, claims errors, and error rate findings.
• Possesses strong communication and organizational skills to successfully deliver education to executive level stakeholders such as internal individuals, Customer officials, and Associations related to new programs or changes within current program policies.
• Builds relationships with subject matter experts within various divisions of Federal and State to support new and existing programs.
• Follows established quality standards for education documentation and assists with corrections or updates as needed to ensure continued Federal and State compliance.
• Analyzes data and tracks trends in claims errors, error rate findings, medical review referrals, and provider inquiries to develop targeted education.
• Assists in monitoring post education trends to evaluate the impact of education on provider inquiries, claims errors, and error rate findings.
• Maintains current and extensive knowledge of Federal and State rules, regulations, processing guidelines, and Internet-Only Manuals (IOM).
• Creates and maintains Federal and State -compliant, Section 508 accessible education materials and web content.
• Coordinates with internal departments to support operational improvement and reduce repeat work through education.
• Serves as a professional subject matter expert in Federal and State -mandated meetings and provider forums.
• Participates in aligning education activities to Federal and State identified risk areas and assists with tracking education focus areas based on inquiry trends, error rate data, and medical review referrals.
• Documents education activities accurately and timely in Federal and State -required systems.
• Supports Federal and State -mandated POE activities including Advisory Groups, ACTs, and reporting requirements.
• Identifies process improvement opportunities and communicates recommendations to management.
• Ensures confidentiality, security, ISO, and Federal and State compliance requirements are met.

Non-Essential Duties and Functions

• Participates in pilot initiatives, special projects, and workgroups.
• Provides backup support during periods of increased workload.
• Performs other related duties consistent with position scope.
• Other duties as assigned.

Minimum Qualifications

• Associate’s degree in Healthcare Administration, Health Information Management, Public Health, Business, Communications, Education, or related field; or equivalent combination of education and experience may be considered including Federal, and State or Medicare experience as determined by Human Resources
• 2 years Medicare experience
• Strong analytical and communication skills
• Experience applying Medicare policy, regulations or processing guidelines

Preferred Qualifications

Above requirements and the following:

• 4 years' Medicare experience
• Provider education or public speaking experience

Environment and Cognitive/Physical Demands

• Ability to read, hear, speak, keyboard, reason, communicate effectively and problem solve
• Requires prolonged sitting and telephone usage
• Requires the use of office equipment such as computer terminals, telephones, copiers and printers
• Infrequent stooping
• Infrequent lifting up to 15 pounds

Segregation of Duties

Every employee is responsible to perform their duties and responsibilities in accordance with Noridian values, policies and procedures, including but not limited to: Segregation of Duties Principles, HIPAA, Security and Privacy, CMS requirements, the Noridian Compliance Program and any other applicable laws, rules and regulations.

Statement of Other Duties

This document describes the essential functions, requirements, and responsibilities of this job, and is not intended to be a complete list of all tasks and functions. Employees may be requested to perform job related tasks other than those specifically listed in this description and may be required to perform any task requested by the supervisor or management.

Total Rewards Package:

Health, Dental and Vision Insurance, Voluntary Insurance Plans, Health Savings and Flexible Spending Accounts, 401k and Company Match, Company-paid Life Insurance, Education Assistance Program, Paid Sick Leave, Paid Holidays, Increasing PTO Accrual Plan, Medical/Parental/Disability Leave, Workers Compensation, Retiree Benefits,Severance Package, Employee Assistance Program, Financial and Health Wellness Benefits, Casual Dress, Open Office Setting, and Online Learning System.

CMS Access Compliance and Regulation Contingency Statement

Some positions require compliance with (i) federal and agency-specific regulations and federal contract requirements, and (ii) eligibility to obtain and maintain federal identity credentials and authorized access to government facilities, information systems, networks, sensitive information, or applications.

To obtain federal identity credentials and authorized access, employees in this position may be required, as a condition of employment, to successfully complete federal identity verification, federal background investigation and adjudication, credentialing, and access authorization processes in accordance with applicable federal requirements. Federal identity credentials and authorized access will not be issued to candidates who have not resided in the United States at least three (3) out of the last five (5) years.

Failure to obtain and maintain eligibility for required federal credentials and access authorization may result in removal from the position or termination of employment.

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)

Below is the salary range for potential new hires.

Salary Range: The pay range for this position is $19.05 - $31.34 hourly, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.

Other Compensation: Incentive Plan & Lifestyle Benefit

This job will be closed 10/05/2026 at 8:00AM CST. No further applications will be considered.

Travel Required

Yes . As needed

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.

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