Provider Engagement Executive

Become a part of our caring community and help us put health first The Provider Engagement Executive develops and grows positive, long-term relationships with physicians, providers and healthcare systems in order to support and improve financial and quality performance within the contracted working relationship with the health plan. The Provider Engagement Executive works on problems of diverse scope and complexity ranging from moderate to substantial. The Provider Engagement Executive represents the scope of health plan/provider relationship across such areas as financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation and coding, HEDIS and STARs performance, operational improvements and other areas as they relate to provider performance, member experience, market growth, provider experience and operational excellence. The Provider Engagement Executive will work with value based Primary Care Physicians and has the potential to work with value-based Specialty programs and providers. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, uses independent judgment requiring analysis of variable factors and determining the best course of action. Use your skills to make an impact Required Qualifications + Minimum of Associate's Degree + 4 or more years of Health care or managed care with Provider Contracting, Network Management or Provider Relations experience + Experience working with HEDIS and/or Stars measures and programs + 1 or more years of demonstrated project management experience + Experience partnering with senior leadership on strategic initiatives + Proven planning, preparation and presenting skills + Demonstrated ability to manage multiple projects and meet deadlines + Comprehensive knowledge of all Microsoft Office applications + Must live within the region (OH, KY, IN, MI, WV) + Ability to travel as needed Preferred Qualifications + Bachelor's Degree + Established knowledge of reimbursement and bonus methodologies + Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses and quality/bonus performance + Comprehensive knowledge of Medicare policies, processes and procedures Additional Information This role is

Created: 2025-11-28