Senior Regional Provider Engagement Manager
Job Title: Senior Regional Provider Engagement ManagerLocation: Remote - Texas, United StatesType: Full Time***Candidate must reside in Austin, San Antonio, or surrounding areas. Role will require both in office presence as well as travel throughout the region***Our client is looking for a Senior Regional Provider Engagement Manager to lead provider performance and engagement initiatives across a multi-market region. This role serves as a strategic partner to market and enterprise leadership, driving measurable improvements in quality, cost, utilization, coding accuracy, and value-based outcomes.Role OverviewThe Senior Regional Provider Engagement Manager acts as a regional leader and trusted advisor, aligning provider engagement strategies with enterprise performance goals. This role focuses on coaching market teams, enabling data-driven provider conversations, and executing high-impact performance initiatives rather than routine provider servicing.Key ResponsibilitiesProvide hands-on leadership and guidance for the Provider Engagement Operating Model (PEOM), coaching market teams on effective, data-driven provider performance discussionsLead in-person and virtual provider performance enablement sessions, new hire performance immersion programs, and rollout of performance-focused initiatives and reportingParticipate in monthly and quarterly regional leadership reviews to assess performance trends, prioritize high-impact provider groups, and align on corrective and growth strategiesLead new provider engagement implementations across assigned regions, emphasizing performance metrics, standardized templates, reporting, and accountability frameworksDrive execution of strategic initiatives targeting provider quality, cost efficiency, risk adjustment accuracy, pharmacy performance, and value-based care outcomesSupport development and execution of operational plans tied directly to provider performance transformation initiativesPartner with health plan and enterprise teams to scale provider performance solutions from pilot programs to full implementationAnalyze and interpret provider performance KPIs, including HEDIS, STARs, medical expense ratios (MER/HBR), risk adjustment, utilization, pharmacy, and value-based performance measuresUse data insights to identify performance gaps and design targeted, measurable improvement action plansLead structured, outcome-focused engagement with high-impact providers to influence performance improvementCollaborate with enterprise Provider Experience and health plan teams to optimize performance in risk-based arrangements across multiple product linesContribute to provider-related enterprise initiatives that advance organization-wide value-based care and performance goalsMonitor industry trends, emerging technologies, and evolving provider performance models to enhance engagement strategiesDevelop and deliver dashboards, reports, and presentations to support provider- and market-level decision-makingEscalate systemic performance barriers and risks to ensure timely resolution and sustained improvementsPartner with operations and vendors to address process or structural barriers impacting provider performanceSupport special projects and additional responsibilities as assignedRequired QualificationsBachelor’s degree in healthcare administration, business, or a related field, or equivalent experience6+ years of experience in provider engagement, network management, or healthcare strategyStrong expertise in provider performance improvement and engagement methodologiesProven success leading cross-functional initiatives and driving results in complex, fast-paced environmentsDemonstrated ability to influence senior leaders and manage large, multi-market initiativesAdvanced analytical skills with experience interpreting performance metrics such as HEDIS, STARs, risk adjustment, cost, and utilizationPreferred QualificationsMaster’s degree in healthcare administration, business, or a related field