Company Statement

EmblemHealth is one of the nation’s largest not for profit health insurers, serving members across New York’s diverse communities with a full range of commercial and government-sponsored health plans for employers, individuals, and families. With a commitment to value-based care, EmblemHealth partners with top hospitals and doctors, including its own AdvantageCare Physicians, to deliver quality, affordable, convenient care. At over a dozen EmblemHealth Neighborhood Care locations, members and non-members alike have access to community-based health and wellness guidance and resources. For more information, visit emblemhealth.com.

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Manager-Provider Engagement - Field

🔍 New York, New York

New

📁: Network & Contracting

💼: EmblemHealth

📅   : 4 days ago Post Date

Summary of Job

Lead and oversee the Provider Relations Field Team, ensuring the team delivers a consistent provider experience across assigned markets and territories. Provide day-to-day leadership, coaching and direction to field representatives, with a focus on accountability, follow-through, provider engagement and timely issue resolution. Drive the field engagement strategy in support of provider experience, retention, growth, quality and broader Provider Network priorities. Serve as a key escalation point for complex provider issues and partner across Network, Operations, Claims, Customer Service, Quality, Sales and other teams to move issues forward and identify broader opportunities for improvement. Deliver executive reports and dashboards on Field Team activity and leverage provider feedback and available data to identify trends, determine where the team should focus and provide leadership with visibility into what is happening in the market. Build and maintain strong relationships with executives at key provider organizations to strengthen provider experience and support growth, quality and organizational performance goals; represent the Field Provider Relations team in cross-functional initiatives.

Responsibilities

Lead, coach and develop Provider Relations Field Representatives, setting clear expectations and providing ongoing feedback and support.
Set team priorities and ensure field activity is aligned to provider needs and organizational priorities across assigned territories.
Monitor team activity, productivity and outcomes; address performance or follow-through gaps and course correct as needed to ensure team and departmental goals are met.
Conduct regular team meetings, one-on-one coaching and field ride-alongs to support development and maintain consistency across the team.
Continuously assess the effectiveness of the field engagement model and recommend enhancements or adjustments to improve team performance, provider engagement and overall outcomes.
Support onboarding and training of new team members and identify opportunities to strengthen team capabilities.
Oversee the team's approach to provider engagement and ensure consistent relationship management across priority providers and markets, including adherence to established playbook standards and best practices.
Guide field representatives in building strong relationships with physicians, practice administrators and provider leadership.
Coach and support field representatives in navigating complex or challenging provider relationships, including developing strategies to address barriers, rebuild engagement and strengthen the overall provider relationship.
Ensure providers receive the appropriate education and support related to programs, policies, operational processes, quality initiatives and provider-facing tools; support the development of additional provider-facing tools as needed.
Identify opportunities to improve provider satisfaction, strengthen relationships and support retention and growth.
Maintain direct relationships with key or high-priority provider organizations when leadership involvement is needed.
Serve as an escalation point for complex or high-priority provider issues that require additional coordination or leadership support.
Partner with Claims, Operations, Customer Service, Quality, Contracting, Sales and other internal teams to move provider issues toward resolution.
Identify recurring themes or systemic issues coming from the field and work with the appropriate teams to address root causes.
Ensure provider issues are documented, tracked and followed through to resolution in accordance with defined service level agreements (SLAs), with clear communication back to providers and internal stakeholders.
Monitor and report on issue resolution performance and escalate barriers that may impact established SLAs or provider experience.
Develop and deliver executive reports and dashboards on Field Team activity, provider engagement trends, performance and outcomes.
Leverage provider feedback and available data to identify trends, opportunities and areas that require leadership attention.
Provide regular updates to leadership on field activity, provider concerns, emerging themes and progress against established team and departmental goals.
Support initiatives tied to provider growth, quality, operational efficiency, network development and overall provider experience.
Use field insights and performance results to recommend changes to workflows, priorities and the field engagement model.
Support broader Provider Network priorities, including provider retention, network development, market expansion and strategic provider initiatives.
Represent the Field Provider Relations function in cross-functional meetings, workgroups and organizational initiatives as needed.
Support implementation and communication of new programs, products, policies and provider-facing initiatives.
Ensure field activities align with contractual, regulatory and organizational requirements.
Support special projects and strategic initiatives as assigned.

Qualifications

Bachelor's degree, preferably in a healthcare-related field, Public Administration, Business Administration, Management or a related field.
5 – 8+ years of relevant healthcare experience, including provider relations, provider network management, managed care, health plan operations, contracting, sales or a related area (Required)
2 – 3+ years of leadership, supervisory or people-management experience (Required)
Strong understanding of healthcare provider operations and managed care, including claims, network operations, provider engagement, quality and reimbursement concepts (Required)
Demonstrated ability to lead, coach and develop employees while managing performance and competing priorities (Required)
Strong relationship-management skills and the ability to work effectively with physicians, practice administrators, provider leadership and internal business partners (Required)
Ability to manage complex provider issues, bring the right teams together and drive follow-through through resolution (Required)
Strong analytical and problem-solving skills with the ability to use data and field feedback to identify trends and determine focus (Required)
Strong organizational, project-management and follow-through skills (Required)
Excellent written, verbal, presentation and interpersonal communication skills with the ability to communicate across different levels of the organization (Required)

Security Disclosure

If you receive a job offer from EmblemHealth, the email will be from “HRTalentAcquisition” with the subject: “Offer of Employment for (job title) – Please respond online.” We will never ask you to join a Google Hangout, buy your own equipment, or pay to apply. We also do not use third-party email services like Yahoo or Gmail.

Pay Disclosure

At EmblemHealth, we prioritize transparency in our compensation practices. We provide a good faith estimate of the salary range for potential hires, which is based on key factors such as role responsibilities, candidate experience, education and training, internal equity, and market conditions. Please be aware that this estimate doesn’t account for geographic differences related to your work location. Typically, new hires may not start at the top of this range, as compensation is tailored to each individual's circumstances. For union positions, salaries will be determined according to the collective bargaining agreement. Join us at EmblemHealth, where your contributions are valued and supported by fair compensation.

EEOC Statement

We value the diverse backgrounds, perspectives, and experiences of our workforce. As an equal opportunity employer, we consider all qualified applicants for employment regardless of race, color, religion, sex, sexual orientation, age, creed, citizenship status, gender identity, pregnancy, marital status, national origin, disability, veteran status, or any other protected characteristic protected by law.

Sponsorship Statement

At EmblemHealth, we are committed to building a diverse and talented workforce. However, we are unable to consider applicants who require, or are likely to require, either before or after hire, visa sponsorship for work authorization in the United States, including but not limited to H-1B, F-1 (STEM OPT), TN, or any other non-immigrant status. Some extremely rare exceptions may apply based on critical business needs.