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The Provider Performance Improvement Field Specialist is responsible for driving quality improvement initiatives and enhancing the performance of dental providers within Avēsis’ dental network by working both remotely and in-person with network providers and their teams. This role involves collaborating with providers, analyzing data, and implementing strategies to improve patient care, provider satisfaction, and overall network performance. The specialist will focus on identifying areas for improvement, developing targeted interventions, and monitoring progress to ensure compliance with clinical best practices, regulatory requirements, and performance expectations.

Competencies:

Functional:

• Analyze provider performance data. Develop and maintain performance reports, dashboards, and scorecards. Monitor provider compliance with guidelines and standards.
• Conduct training sessions, workshops, and webinars. Provide individualized coaching to underperforming providers.
• Develop and implement performance improvement programs. Collaborate with internal teams to execute initiatives. Align efforts with organizational goals and compliance standards.
• Use analytics to assess interventions. Provide recommendations based on data and benchmarking. Identify and promote best practices.
• Ensure compliance with regulations and standards. Monitor adherence to clinical guidelines. Assist in audit and accreditation preparation.
• Analyze member feedback and satisfaction surveys. Implement strategies to improve communication and care delivery.

Core:

• Collegiality: building strong relationships on company-wide, approachable, and helpful, ability to mentor and support team growth.
• Initiative: readiness to lead or take action to achieve goals.
• Communicative: ability to relay issues, concepts, and ideas to others easily orally and in writing.
• Member-focused: going above and beyond to make our members feel seen, valued and appreciated.
• Detail oriented and thorough: managing and completing details of assignments without too much oversight.
• Flexible and responsive: managing new demands, changes, and situations.
• Critical Thinking: effectively troubleshoot complex issues, problem solve and multi-task.
• Integrity & responsibility: acting with a clear sense ownership for actions, decisions and to keep information confidential when required.
• Collaborative: ability to represent your own interests while being fair to those representing other or competing ideas in search of a workable solution for all parties.

Behavioral:

• Foster positive relationships with providers. Act as a liaison between providers and the organization. Address concerns and facilitate communication.
• Promote best practices and evidence-based care. Motivate and support providers through coaching.
• Work cross-functionally with internal teams. Share knowledge and align on quality goals.
• Deliver clear, persuasive training and feedback. Communicate performance expectations and improvement strategies.
• Assist in resolving provider grievances. Address non-compliance or performance issues constructively

Minimum Qualifications:

• Associates degree or equivalent education and work experience in a similar role. High School Degree or equivalent required.

• 2+ years’ experience in healthcare quality improvement, provider relations, or a similar role.
• 2+ years of experience in managed care government programs, such as Medicaid and Medicare.
• Ability to travel within the state of Mississippi 75% of working hours.
• A valid driver's license with proof of auto insurance and the ability to use your own vehicle.
• The ability to accelerate impact and effectively collaborate across multiple teams toward attaining common goals and objectives.
• Strong written and verbal communication skills with focus on detail and concise, objective, relevant documentation.

Preferred Qualifications:

• Familiarity with dental clinical guidelines, best practices, and regulatory requirements.
• Strong analytical skills, with experience in data analysis and performance metrics.
• Excellent communication, presentation, and interpersonal skills, with the ability to engage and influence dental providers.
• Knowledge of quality improvement methodologies, such as Lean, Six