Provider Engagement Manager

Hawaii Medical Service Association•Honolulu, HI

About The Position

The Provider Engagement Manager leads recurring Provider Pod meetings for assigned provider organizations, coordinates internal subject matter experts, and presents performance findings to providers. The role manages value-based performance reviews and action planning across financial, operational, and clinical areas, including revenue cycle optimization, Medicare STAR quality gaps, risk adjustment, coding and documentation, cost of care, utilization, referrals, preventive care, and clinical quality measures. The manager serves as the strategic liaison between provider organizations—including IPAs, systems, and ACOs—and the MSO. The role builds relationships with physician leaders and practice administrators, identifies operational barriers, coordinates resources to address provider concerns, and promotes MSO programs, tools, and best practices. It analyzes performance trends, develops and monitors improvement plans, presents dashboards and recommendations, and collaborates with cross-functional teams. Other responsibilities may be assigned or directed.

Requirements

Bachelor's degree and three years of related experience, or an equivalent combination of education and work experience.
Experience facilitating leadership and senior leadership meetings.
Strong knowledge of healthcare reimbursement models.
Two years of leadership experience.

Responsibilities

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 Senior Data Analyst.
Present findings in Provider Pod meetings to rank-and-file providers.
Lead performance reviews and action planning related to revenue cycle optimization, Medicare STAR quality gap closure, risk adjustment factor optimization, suspect condition validation and documentation improvement, HCC coding, cost of care reduction, emergency department utilization, hospital admissions, readmission reduction, specialist referral optimization, preventive care, and clinical quality measures.
Build trusted relationships with physician leaders and practice administrators.
Serve as the primary strategic liaison between provider organizations, IPAs, systems, or ACOs and the MSO.
Identify operational barriers affecting provider performance.
Coordinate internal resources to resolve provider concerns.
Promote adoption of MSO programs, tools, and best practices.
Analyze provider performance trends and develop action plans to improve financial and clinical outcomes.
Monitor progress toward established performance goals.
Present performance dashboards and recommendations.
Partner with Revenue Cycle, Clinical Operations, Care Management, Coding and Documentation, Quality Improvement, Provider Contracting, Population Health Analytics, Pharmacy, and Network Operations teams.
Perform other miscellaneous responsibilities and duties as assigned or directed.