Provider Engagement Manager Full Time NEW

Job Title : Provider Engagement Manager

Location : Washington, United States

Job Type : Full Time

Our client is seeking a dynamic Provider Engagement Manager to lead strategic initiatives focused on improving quality outcomes and risk adjustment performance across their healthcare network. This role will partner closely with key provider groups, particularly high-impact and complex value-based care partners, to drive measurable improvements in clinical and financial performance.

The position focuses on building strong provider relationships, delivering data-driven insights, and implementing engagement strategies that enhance care delivery, optimize performance metrics, and support overall health outcomes.

Key Responsibilities

• Develop and execute tailored engagement plans for Tier 1 providers to achieve annual quality and risk adjustment targets; support Tier 2 providers as needed
• Partner closely with healthcare providers through regular meetings, performance reviews, and action planning to improve outcomes and coding accuracy
• Identify operational and clinical barriers within provider practices and work collaboratively to implement effective solutions
• Promote adoption of quality and risk adjustment programs, including data integration, EMR connectivity, and provider collaboration platforms
• Monitor and document engagement activities using standardized tools to track effectiveness and ensure consistency across the organization
• Act as a subject matter expert on provider engagement strategies, ensuring alignment with broader health plan objectives
• Mentor and support team members by providing training, guidance, and escalation support when needed
• Utilize standard reporting tools and educational materials to drive provider performance improvements
• Coordinate with internal teams to facilitate data sharing, documentation best practices, and patient engagement efforts
• Assist in developing, refining, and implementing operational processes in line with organizational policies
• Communicate effectively with physicians, clinical leaders, and practice staff across assigned provider networks
• Ensure strict adherence to compliance standards and regulatory requirements
• Travel within the assigned region as needed (up to approximately 80%)

Qualifications

Required

• Bachelor’s degree in Business, Healthcare, Nursing, or a related field (or equivalent experience)
• Minimum of 5 years of experience in provider engagement, quality improvement, practice transformation, or managed care environments
• Experience working with various provider reimbursement models, including fee-for-service, value-based care, and capitation
• Strong understanding of healthcare quality metrics and risk adjustment principles across multiple lines of business
• Demonstrated data analysis capabilities with the ability to translate insights into actionable strategies
• Proficiency with tools such as Excel, PowerPoint, and Visio
• Excellent communication and stakeholder management skills
• Proven ability to lead initiatives and influence provider performance

Core Competencies

• Strong leadership and relationship-building skills
• Analytical mindset with attention to detail
• Ability to manage multiple stakeholders and priorities
• Comfortable working in cross-functional, fast-paced environments
• Solution-oriented approach to problem-solving