Provider Engagement Manager

Hawaii Medical Service Association; Honolulu (HI); Hybrid; USD 87,000 - 180,000; Full time

Job summary

Hawaii Medical Service Association in Hawaii seeks a Provider Engagement Manager to be the primary operational relationship manager for an assigned portfolio of provider organizations within the Enablecare MSO. You will lead multidisciplinary Provider Pod meetings and collaborate with physician practices to enhance clinical quality, risk adjustment performance, and revenue cycle operations.

The role functions as a strategic advisor, coordinating cross-functional MSO resources and ensuring

Qualifications

• Bachelor's degree and three years of related experience; or an equivalent combination of education and work experience.
• Experience facilitating leadership and sr. 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 the Senior Data Analyst and present findings in POD meetings.
• Lead performance reviews and action planning related to revenue cycle optimization, risk adjustment, and quality improvements.
• Build trusted relationships with physician leaders and practice administrators and act as the strategic liaison between provider organizations and the MSO.
• Analyze provider performance trends and develop action plans to improve financial and clinical outcomes.
• Collaborate cross-functionally with Revenue Cycle, Clinical Operations, Care Management, Coding and Documentation, Quality Improvement, and other teams.

Skills

Meeting facilitation

Leadership

Relationship management

Healthcare reimbursement knowledge

Education

Bachelor's degree or equivalent

Job description

**Hybrid Work Environment - Must reside in Hawaii **

Pay Range: $86,500 - $179,500

Note: Individuals typically begin between the minimum to middle of the pay range

Enablecare is a new organization launched to help physicians and provider organizations across Hawaiʻi succeed in value-based care. As a Management Services Organization (MSO), Enablecare equips practices with the data, operational support, and clinical and financial expertise they need to improve quality, reduce administrative burden, and deliver better health outcomes for the people of Hawaii. Launching January 1, 2027, Enablecare offers a rare opportunity to help build a mission-driven organization from the ground up.

The Provider Engagement Manager serves as the primary operational relationship manager for an assigned portfolio of provider organizations participating in the Enablecare Management Services Organization (MSO). This position along with the Sr. Operations Manager leads multidisciplinary Provider Pod meetings and partners closely with physician practices to improve clinical quality, risk adjustment performance, revenue cycle operations, and total cost of care.

The Manager functions as the strategic advisor to provider organizations by coordinating cross-functional MSO resources and ensuring practices have the tools and support necessary to succeed under value-based care arrangements.

Minimum Qualifications

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

Duties and 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 the Senior Data Analyst.
  
  • Present findings in the POD meetings to rank-and-file providers.
• Value-Based Performance Management
  
  • Lead performance reviews and action planning related to:
    
    • Revenue cycle optimization and issue resolution
    • Medicare STAR quality gap closure opportunities
    • Risk Adjustment Factor (RAF) optimization
    • Suspect condition validation and documentation improvement
    • HCC coding opportunities
    • Cost of care reduction initiatives
    • Emergency Department utilization
    • Hospital admissions
    • Readmission reduction
    • Specialist referral optimization
    • Preventive care performance
    • Clinical quality measures
• Provider Relationship Management
  
  • Build trusted relationships with physician leaders and practice administrators.
  • Serve as the primary strategic liaison between the (provider organization / IPAs / Systems / ACOs) and the MSO.
  • Identify operational barriers impacting provider performance.
  • Coordinate internal resources to resolve provider concerns.
  • Promote adoption of MSO programs, tools, and best practices.
• Performance Improvement
  
  • Analyze provider performance trends.
  • Develop action plans to improve financial and clinical outcomes.Monitor progress toward established performance goals.
  • Present performance dashboards and recommendations.
• Cross-Functional Collaboration
  
  • Partner with teams responsible for:
    
    • Revenue Cycle
    • Clinical Operations
    • Care Management
    • Coding and Documentation
    • Quality Improvement
    • Provider Contracting
    • Population Health
    • Analytics
    • Pharmacy
    • Network Operations
• Performs all other miscellaneous responsibilities and duties as assigned or directed.

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact808-948-5588 or via email at [e-mail].

EEO is the Law