Engagement Manager – Provider Network Management

This is a fully remote position, open to applicants in Nevada.

📋 Description

• Develop and maintain strong, consultative relationships with designated provider networks to enhance engagement and fulfill client requirements.

• Educate and assist providers in navigating Utilization Management processes, including prior authorizations, reviews of medical necessity, and adherence to evidence-based care guidelines.

• Act as a primary liaison between providers and the Utilization Management team, ensuring effective communication, resolution of issues, and ongoing support.

• Oversee the implementation, education, and sustained engagement for referral benefits and workflows, serving as an in-market expert.

• Collaborate with internal teams to execute engagement strategies, deliver educational sessions for providers, and analyze data to pinpoint opportunities for intervention and enhancement.

• Establish relationships with key stakeholders and advocate for WellSky solutions.

• Provide regular updates regarding provider engagement performance, program feedback, and market insights to internal teams and clients.

• Collaborate with marketing and operational teams to develop educational and promotional materials that support provider engagement initiatives.

• Monitor provider performance and engagement trends, analyzing Utilization Management-related data to identify intervention opportunities, optimize workflows, and improve patient outcomes.

• Perform additional duties as assigned.

⛳️ Requirements

• Minimum of 4-6 years of relevant work experience.

• Bachelor's Degree or equivalent professional experience.

• Demonstrated ability to engage, educate, and influence healthcare providers, ideally in a Utilization Management or care management environment.

• Comprehensive understanding of Utilization Management principles, payer-provider interactions, and prior authorization workflows.

• Experience in provider education, network engagement, or compliance monitoring.

• Ability to analyze data to inform strategic engagement efforts.

• Experience in articulating scorecards, performance metrics, and strategies for provider outreach.

• Background in coaching and developing clinical programs aimed at enhancing provider quality metrics.

• Willingness to travel up to 30% based on business requirements.

• Flexibility to work additional or irregular hours as necessary.

• Must adhere to applicable security policies and procedures to protect company and client information.

• Ability to sit and view a computer screen for prolonged periods.

• Candidates for U.S.-based positions must be legally authorized to work in the United States.

• Certain client-facing roles may need to comply with specific requirements, such as immunizations and occupational health mandates.

🏝️ Benefits

• Comprehensive medical coverage including prescription, dental, and vision benefits.

• Mental health support available through the Employee Assistance Program (EAP).

• Generous paid time off, in addition to 13 paid holidays.

• 100% vested 401(K) retirement plans.

• Educational assistance of up to $2500 per year.