Provider Engagement Specialist I/II

Blue Cross of Idaho

Provider Engagement Specialist enhancing provider relationships and supporting health initiatives. Develops training content and maintains provider education materials for risk adjustment programs.

Posted 8/1/2026full-timeCoeur D'Alene • Idaho • 🇺🇸 United StatesJuniorMid-Level💰 $66,353 - $92,894 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in risk adjustment coding and provider education, ensuring compliance with regulatory standards while enhancing provider relationships and performance metrics. Proficient in analyzing performance reports and leading improvement projects to maximize value-based reimbursements.

Highest-signal resume keywords

Certified Professional Coder Certification (CPC)Certified Risk Coder CertificationProvider Education DevelopmentRisk Adjustment Performance AnalysisClinical Documentation Management

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Risk Adjustment CodingMedical Record ReviewPerformance Metrics DevelopmentClinical Documentation ImprovementData AnalysisRegulatory ComplianceProvider Relationship ManagementTraining DevelopmentPerformance Improvement ProjectsCoding Guidelines Interpretation

Soft Skills

CommunicationInfluencingCollaborationLeadershipOrganizational Skills

Certifications & Qualifications

Certified Professional Coder Certification (CPC)Certified Risk Coder Certification

Industry Keywords

Provider ServiceHealth IndustryValue-Based ReimbursementRisk Adjustment ProgramsCompliance Standards

About the role

Key responsibilities & impact

Promotes and enhances relationships with providers to invest in the health of members
Responsible for the overall performance of assigned practices within risk adjustment programs
Develops content and conducts training to assigned practices
Influences, develops, and maintains provider education materials related to risk adjustment
Manages and coordinates the creation, distribution and collection of clinical documentation and coding improvement tools
Analyzes and interprets provider risk adjustment performance reports
Develops and implements plans to meet target performance metrics
Interprets and maintains current risk adjustment regulatory rules and guidelines to ensure compliance standards are maintained within internal policies, procedures, and workflows
Analyzes reporting or provider education programs to identify opportunities for education and/or enhanced reporting
Identifies and leads performance improvement projects that maximize provider value-based reimbursements
Performs risk adjustment medical record reviews as a primary coder and communicates findings to providers

Requirements

What you’ll need

Level I: 2/+ years’ provider service, coding, or health industry experience
Level II: 4/+ years’ provider service, coding, or health industry experience
Bachelor’s Degree or equivalent work experience (Two years’ relevant work experience is equivalent to one-year college)
Must hold: Certified Professional Coder Certification (CPC) or Clinical Certification/Clinical License (MA or above)
Certified Risk Coder Certification, or must obtain within one year of date of hire

Benefits

Comp & perks

paid time off
paid holidays
community service and self-care days
medical/dental/vision/pharmacy insurance
401(k) matching and non-contributory plan
life insurance
short and long term disability
education reimbursement
employee assistance plan (EAP)
adoption assistance program
paid family leave program