Care Transformation Specialist

Department Name: Care Transformation

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.

This is a highly relationship-driven role that requires a strong healthcare background and excellent communication skills. As a Care Transformation Specialist , you will leverage your knowledge of Medicare, Medicaid, private insurance, and Accountable Care Organizations (ACOs) to educate, support, and build partnerships with providers and their office teams. You will manage an assigned territory of provider practices throughout Arizona, engaging with practices through phone calls, email, and in-person visits. The ideal candidate will reside in Maricopa County with the understanding that in-person visits may need to be conducted outside of Maricopa County.

This is not an entry-level position. Candidates must possess a strong working knowledge of Medicare and Medicaid programs, including an understanding of health plan operations, CMS regulations, AHCCCS requirements, and regulatory deliverables. Experience supporting Medicaid Behavioral Health and Long-Term Care populations is highly desirable. Preferred qualifications include knowledge of private insurance plans, accountable care organizations (ACOs), clinically integrated networks, skilled nursing, and other value-based care models. The ideal candidate will be able to build and maintain strong relationships with physicians and office staff, confidently educate providers on complex healthcare topics, and effectively communicate with stakeholders at all levels through both written and verbal interactions. Strong presentation and public speaking skills are essential, along with the ability to simplify complex information and deliver it in an engaging, professional manner.

The ideal candidate is a self-starter with strong critical thinking skills, adaptability, and the ability to work independently in a fast-paced, changing environment. Exceptional verbal and written communication skills are essential, including the ability to build rapport quickly, communicate professionally over the phone, and present information clearly and confidently. Public speaking experience is required, including developing presentation content and delivering training or educational sessions to providers, partners, and peers. Strong proficiency in Microsoft Excel is also required. Candidates must be personable, approachable, and able to engage providers and staff effectively while representing the organization in a professional manner.

Your work schedule will be primarily Monday-Friday Arizona business hours. Some flexibility in days and hours will be required to meet the needs of the practices. Your work location will be hybrid. You must reside in Maricopa County Arizona for this role. If this role sounds like the one for you, Apply Today!

Banner Plans & Networks (BPN) 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 BPN, 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.

Estimated Pay Range:

$26.40 - $44.00 / hour Banner Health is committed to pay equity and transparency. The posted compensation range is a reasonable estimate that extends from the lowest to the highest pay Banner Health in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. This range is based on possible base salaries and does not include the value of our total rewards package. Actual pay determined at offer will be based on years of relevant work experience, education, certifications, skills, and geographic location, along with a review of current employees in similar roles to ensure pay equity is achieved and maintained.

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