PROLIM (www.prolim.com) is currently seeking Provider Engagement Account Manager for one of our top Client for Location - Remote - Territory is Bartow County, GA but candidate can live in Cherokee ...
Quick apply
PROLIM (www.prolim.com) is currently seeking Provider Engagement Account Manager for one of our top Client for Location - Remote - Territory is Bartow County, GA but candidate can live in Cherokee ...
Quick apply
PROLIM (www.prolim.com) is currently seeking Provider Engagement Account Manager for one of our top Client for Location - Remote - Territory is Bartow County, GA but candidate can live in Cherokee ...
PROLIM (www.prolim.com) is currently seeking Provider Engagement Account Manager for one of our top Client for Location - Remote - Territory is Bartow County, GA but candidate can live in Cherokee ...
PROLIM (www.prolim.com) is currently seeking Provider Engagement Account Manager for one of our top Client for Location - Remote - Territory is Bartow County, GA but candidate can live in Cherokee ...
Queens, NY · On-site
$30/hr
Provider Engagement Project Specialist (Part Time Temporary) Program/ Department: Research & Evaluation Division: Mental Hygiene Bureau: Bureau of Alcohol and Drug Us Location: 42-09 28th St, Long ...
Queens, NY · On-site
$30/hr
Provider Engagement Project Specialist (Part Time Temporary) Program/ Department: Research & Evaluation Division: Mental Hygiene Bureau: Bureau of Alcohol and Drug Us Location: 42-09 28th St, Long ...
Astoria, NY · Hybrid
$30/hr
Provider Engagement Project Specialist (Part Time Temporary) Program/ Department: Research & Evaluation Division: Mental Hygiene Bureau: Bureau of Alcohol and Drug Us Location: 42-09 28th St, Long ...
Astoria, NY · Hybrid
$30/hr
Provider Engagement Project Specialist (Part Time Temporary) Program/ Department: Research & Evaluation Division: Mental Hygiene Bureau: Bureau of Alcohol and Drug Us Location: 42-09 28th St, Long ...
Miami, FL · On-site
Position Description: 1. Acts as a liaison between claims and credentialing departments. 2. Fields, resolves, and/or escalates issues raised by participating and non-participating providers including ...
Quick apply
Miami, FL · On-site
Position Description: 1. Acts as a liaison between claims and credentialing departments. 2. Fields, resolves, and/or escalates issues raised by participating and non-participating providers including ...
Wilkes Barre, PA · On-site +1
The leader oversees the team's engagement with provider entities on performance-related initiatives, including Value-Based Reimbursement (VBR), Stars, and Risk capture, as well as other ...
Wilkes Barre, PA · On-site +1
The leader oversees the team's engagement with provider entities on performance-related initiatives, including Value-Based Reimbursement (VBR), Stars, and Risk capture, as well as other ...
Camp Hill, PA · On-site +1
The leader oversees the team's engagement with provider entities on performance-related initiatives, including Value-Based Reimbursement (VBR), Stars, and Risk capture, as well as other ...
Camp Hill, PA · On-site +1
The leader oversees the team's engagement with provider entities on performance-related initiatives, including Value-Based Reimbursement (VBR), Stars, and Risk capture, as well as other ...
Provider Engagement Specialist Location: Triad Region, North Carolina (Winston-Salem, Greensboro, Burlington) Work Environment: Field-Based | Up to 80% Travel (Local Market) Overview The Provider ...
Provider Engagement Specialist Location: Triad Region, North Carolina (Winston-Salem, Greensboro, Burlington) Work Environment: Field-Based | Up to 80% Travel (Local Market) Overview The Provider ...
The leader oversees the team's engagement with provider entities on performance-related initiatives, including Value-Based Reimbursement (VBR), Stars, and Risk capture, as well as other ...
The leader oversees the team's engagement with provider entities on performance-related initiatives, including Value-Based Reimbursement (VBR), Stars, and Risk capture, as well as other ...
Henderson, NV · On-site
$85K - $100K/yr
The Provider Engagement Manager (PEM) is responsible for establishing new relationships with primary care clinic leadership, providers and staff as well as maintaining strategic relationships with ...
Henderson, NV · On-site
$85K - $100K/yr
The Provider Engagement Manager (PEM) is responsible for establishing new relationships with primary care clinic leadership, providers and staff as well as maintaining strategic relationships with ...
Tyler, TX · Remote
$45K - $80K/yr
Job Summary Provides support for health plan provider engagement activities. Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures smaller, less ...
Tyler, TX · Remote
$45K - $80K/yr
Job Summary Provides support for health plan provider engagement activities. Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures smaller, less ...
Long Beach, CA · On-site +1
$45K - $88K/yr
Job Summary Provides support for health plan provider engagement activities. Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures smaller, less ...
Long Beach, CA · On-site +1
$45K - $88K/yr
Job Summary Provides support for health plan provider engagement activities. Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures smaller, less ...
Long Beach, CA · Remote
$40K - $46K/yr
Job Summary Provides support for health plan provider engagement activities. Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures smaller, less ...
Long Beach, CA · Remote
$40K - $46K/yr
Job Summary Provides support for health plan provider engagement activities. Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures smaller, less ...
Clarksville, TX · Remote
$45K - $80K/yr
Job Summary Provides support for health plan provider engagement activities. Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures smaller, less ...
Clarksville, TX · Remote
$45K - $80K/yr
Job Summary Provides support for health plan provider engagement activities. Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures smaller, less ...
Mount Pleasant, TX · Remote
$45K - $80K/yr
Job Summary Provides support for health plan provider engagement activities. Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures smaller, less ...
Mount Pleasant, TX · Remote
$45K - $80K/yr
Job Summary Provides support for health plan provider engagement activities. Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures smaller, less ...
Long Beach, CA · Remote
$45K - $80K/yr
Job Summary Provides support for health plan provider engagement activities. Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures smaller, less ...
Long Beach, CA · Remote
$45K - $80K/yr
Job Summary Provides support for health plan provider engagement activities. Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures smaller, less ...
Texarkana, TX · Remote
$45K - $80K/yr
Job Summary Provides support for health plan provider engagement activities. Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures smaller, less ...
Texarkana, TX · Remote
$45K - $80K/yr
Job Summary Provides support for health plan provider engagement activities. Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures smaller, less ...
The Provider Engagement Manager (PEM) is responsible for establishing new relationships with primary care clinic leadership, providers and staff as well as maintaining strategic relationships with ...
The Provider Engagement Manager (PEM) is responsible for establishing new relationships with primary care clinic leadership, providers and staff as well as maintaining strategic relationships with ...
Queens, NY · On-site
$115K - $120K/yr
Provider Engagement Account Executive Location: Queens, NY & The Bronx, NY Work Type: Hybrid (Remote + 30-50% Field Travel) Job Type: Full-time | Permanent Industry: Healthcare Salary Range: $115,000 ...
Quick apply
Queens, NY · On-site
$115K - $120K/yr
Provider Engagement Account Executive Location: Queens, NY & The Bronx, NY Work Type: Hybrid (Remote + 30-50% Field Travel) Job Type: Full-time | Permanent Industry: Healthcare Salary Range: $115,000 ...
As Director of Quality and Provider Engagement, you will have a direct seat at the table for both strategy and operations, shaping the future of care for more than 350,000 lives. Role Overview: * The ...
As Director of Quality and Provider Engagement, you will have a direct seat at the table for both strategy and operations, shaping the future of care for more than 350,000 lives. Role Overview: * The ...
$27K - $37K
8% of jobs
$37K - $46.9K
8% of jobs
$53.5K is the 25th percentile. Wages below this are outliers.
$46.9K - $56.9K
13% of jobs
$56.9K - $66.8K
13% of jobs
The median wage is $72.5K / yr.
$66.8K - $76.8K
15% of jobs
$76.8K - $86.7K
14% of jobs
$91.3K is the 75th percentile. Wages above this are outliers.
$86.7K - $96.7K
11% of jobs
$96.7K - $106.6K
6% of jobs
$106.6K - $116.6K
6% of jobs
$116.6K - $126.5K
4% of jobs
$126.5K - $136.5K
2% of jobs
$27K
$77.8K
$136.5K
To thrive as a Provider Engagement professional, you need a background in healthcare administration, strong relationship management skills, and a solid understanding of provider network operations. Familiarity with Customer Relationship Management (CRM) systems, provider directories, and compliance regulations is often required, and certifications in healthcare management can be beneficial. Exceptional communication, problem-solving, and negotiation skills make you stand out in this position. These competencies are crucial for effectively building partnerships, resolving provider concerns, and enhancing network performance within complex healthcare environments.
A Provider Engagement job focuses on building and maintaining relationships with healthcare providers to ensure they are informed, engaged, and supported in delivering quality care. Responsibilities often include provider education, communication, problem-solving, and collaboration with internal teams to enhance provider experience. These roles exist in healthcare organizations, insurance companies, and managed care settings. Success in provider engagement requires strong communication, organizational, and relationship-management skills.
A typical day as a Provider Engagement professional involves communicating with healthcare providers to address their needs, answering questions about network participation, and ensuring compliance with organizational guidelines. You’ll often analyze provider feedback, coordinate with internal teams like credentialing or contracting, and develop strategies to improve provider satisfaction and network quality. The work is dynamic and collaborative, requiring you to juggle multiple projects and solve challenges as they arise. This variety makes the role both engaging and impactful, while offering regular opportunities to build long-term professional relationships.

PROLIM (www.prolim.com) is currently seeking Provider Engagement Account Manager for one of our top Client for Location - Remote - Territory is Bartow County, GA but candidate can live in Cherokee, Pickens, Floyd or Bartow due to field travel required 4 days a week
Qualified candidates can directly send your updated resume and contact info via email: jayaprakash.hiremath@prolim.com
Job description:
***NOTE: For this role, due to travel requirements, we are seeking candidates who live in Georgia, specifically, Bartow, Cherokee, Floyd or Pickens counties***
Position Purpose:
Maintain partnerships between the health plan and the contracted provider networks serving our communities.
Build client relations to ensure delivery of the highest level of care to our members.
Engage with providers to align on network performance opportunities and solutions, and consultative account management and accountability for issue resolution.
Drive optimal performance in contract incentive performance, quality, and cost utilization.
Serve as primary contact for providers and act as a liaison between the providers and the health plan
Triages provider issues as needed for resolution to internal partners
Receive and effectively respond to external provider related issues
Investigate, resolve and communicate provider claim issues and changes
Initiate data entry of provider-related demographic information changes
Educate providers regarding policies and procedures related to referrals and claims submission, web site usage, EDI solicitation and related topics
Perform provider orientations and ongoing provider education, including writing and updating orientation materials
Manages Network performance for assigned territory through a consultative/account management approach
Evaluates provider performance and develops strategic plan to improve performance
Drives provider performance improvement in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS/quality, cost and utilization, etc.
Completes special projects as assigned
Ability to travel locally 4 days a week
Performs other duties as assigned
Complies with all policies and standards
Direct Provider Engagement: Conducts regular in-person visits with physicians to provide real-time support, discuss performance metrics, and identify opportunities for improvement in patient care and clinical practices.
Value-Based Care Model: Focuses on value-based care model initiatives, collaborating with physicians to identify and align to performance-based agreements that incentivize better patient outcomes, cost-efficiency, and quality care.
Performance Management: Uses data analytics to track and monitor provider performance, offering actionable feedback to help physicians optimize care delivery and meet key performance targets.
Education/Experience:
Bachelor’s degree in related field or equivalent experience
Two years of provider engagement account management experience
Project management experience at a medical group, IPA, or health plan setting
Proficient in HEDIS/Quality measures, cost (MLR) and utilization
Required Skills
* In person provider engagement experience.
* Risk experience (Health Benefit Ratio, emergency room utilization, cost utilization-reducing high-cost drivers)
Preferred or Nice-to-have Skills
* HEDIS/Quality Improvement
* Value-based care
* Claims processing knowledge
Years of Experience: * Bachelor’s degree in related field or equivalent experience and 2 years in person provider engagement experience
Industry Experience: * Managed care * Accountable Care Organization (ACO) or Independent Practice Association (IPA) experience
Education Requirements: * Bachelor’s degree in related field or equivalent experience
About PROLIM
PROLIM is a leading provider of PLM, IoT and Digital transformation solutions to Global Fortune 1000 companies. With 9 global offices in US, India, and Australia, PROLIM has won 30+ awards and proudly serving over 1200+ customers to innovate and improve their profitability and efficiency. PROLIM was founded in 2005 and is headquartered in Farmington Hills, USA. With the global footprint and expertise in latest technologies, PROLIM can partner with you to speed up your Digital Transformation journey.