Provider Engagement Manager

1. Provider Pod Leadership
   
   • Lead recurring Provider Pod meetings for assigned provider organizations.
   • Develop meeting agendas and facilitate productive discussions.
   • Coordinate participation from internal subject matter experts.
   • Track action items and ensure accountability for completion.
   • Aggregate data with the Senior Financial Analyst and the Senior Data Analyst.
     
     • Present findings in the POD meetings to rank-and-file providers.
2. Value-Based Performance Management
   
   • Lead performance reviews and action planning related to:
     
     • Revenue cycle optimization and issue resolution
     • Medicare STAR quality gap closure opportunities
     • Risk Adjustment Factor (RAF) optimization
     • Suspect condition validation and documentation improvement
     • HCC coding opportunities
     • Cost of care reduction initiatives
     • Emergency Department utilization
     • Hospital admissions
     • Readmission reduction
     • Specialist referral optimization
     • Preventive care performance
     • Clinical quality measures
3. Provider Relationship Management
   
   • Build trusted relationships with physician leaders and practice administrators.
   • Serve as the primary strategic liaison between the (provider organization / IPAs / Systems / ACOs) and the MSO.
   • Identify operational barriers impacting provider performance.
   • Coordinate internal resources to resolve provider concerns.
   • Promote adoption of MSO programs, tools, and best practices.
4. Performance Improvement
   
   • Analyze provider performance trends.
   • Develop action plans to improve financial and clinical outcomes.
   • Monitor progress toward established performance goals.
   • Present performance dashboards and recommendations.
5. Cross-Functional Collaboration
   
   • Partner with teams responsible for:
     
     • Revenue Cycle
     • Clinical Operations
     • Care Management
     • Coding and Documentation
     • Quality Improvement
     • Provider Contracting
     • Population Health
     • Analytics
     • Pharmacy
     • Network Operations
6. Performs all other miscellaneous responsibilities and duties as assigned or directed.

#LI-Hybrid

1. Bachelor's degree and three years of related experience; or an equivalent combination of education and work experience.
2. Experience facilitating leadership and sr. leadership meetings.
3. Strong knowledge of healthcare reimbursement models.
4. Two years of leadership experience.