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Manager Provider Engagement

Job Posting
Manager Provider Engagement
Job Details
Job Type


Greensboro, NC • Provider Relations
Job Summary

The Manager Provider Engagement is responsible for helping develop the physician performance strategy and plan; creating and distributing content and communications for education and awareness; measuring and collaborating with physicians, practices, and accountable care organizations on practice performance including quality, CMS Stars, and risk performance. This position is key to HTA value-based contracting and population health strategies and helping the company meet its goals and objectives.

Major Work Activities

Work with the company leadership to develop the strategy and drive high physician satisfaction and engagement leading to increased member satisfaction and growth, including but not limited to: physician and office staff onboarding, education, and training
Develop and implement a performance and improvement plan using key performance metrics to measure physician, practice, and accountable care organization performance against desired goals and outcomes, including but not limited to quality, Medicare Stars measures, HEDIS, CAHPS, HOS, and risk adjustment
Develop relationships with clinical providers/staff and communicate performance, quality, coding, and documentation guidelines
Deliver presentations to providers and office staff on health plan quality and coding initiatives guidelines and requirements of the CMS Star measures and risk adjustment program to ensure correct coding and documentation
Facilitate and lead joint operating committee (JOC) and joint clinical committee (JCC) meetings with practices and accountable care organizations, collaborating with key areas of the company to ensure performance
Be the key point of contact for physicians, practices, and accountable care organizations to help resolve their inquiries related to utilization management, benefits, claims, and contracting
Work with leaders of the company on provider contracting, credentialing committee, and provider oversight committee
Collaborate with company leaders on product development and performance to identify provider abrasion
Assist with the development, implementation, and measurement of physician incentive plans
Manage and supervise assigned staff and intercompany support relationships to accomplish the goals of the Company
Ability to drive within assigned areas, travel 75-85 % in the market region to providers' offices
Capacity to attend provider meetings day/evening/weekends as needed within assigned areas
Ability to adapt to changing health services landscape and pivot based on business needs of the organization
Other duties as assigned


Minimum Qualifications

Required Education

Bachelor’s degree in business administration health care administration or related field, or five plus years’ equivalent healthcare work experience or any combination of education and experience which would provide an equivalent background

Required Licensure/Certification

Annual Flu Vaccine
COVID-19 Vaccine
Required Experience and Knowledge

Five plus years of experience in provider engagement, population health, or provider performance
Three plus years of management/leadership experience
One year or more experience working with healthcare data
Prior experience as a physician practice administrator or working with physician practices strongly preferred
Working knowledge of industry-leading value-based contracting strategies
Knowledge of healthcare operations
Knowledge of Medicare Advantage, including Stars, HEDIS, risk adjustment
Required Skills, and Abilities

Proven quantitative and qualitative analytical skills and scenario planning
Excellent written and verbal communication in one-on-one settings and in public
Highly effective at building rapport, credibility, and trust across multiple audiences
Strong decision-making and problem-solving skills
Proficient in business software (e.g., MS Office products)
Preferred Education

Master’s degree in business or healthcare-related field

Required Licensure/Certification

Certified Coding Specialist

Time:  Full time
Salary:  Salary
Category:  Administration

Updated: 7/15/2022 2:39:17 PM

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7800 McCloud Road
Greensboro, NC 27409