Engagement Manager - Provider Network Management

Role Description

The engagement manager plays a critical role in fostering strong relationships with healthcare providers participating in a Utilization Management (UM) program. This role is responsible for educating providers on UM processes, promoting best practices for prior authorization and care coordination, and driving engagement to improve compliance and patient outcomes.

Key Responsibilities:

• Cultivate strong, consultative relationships with assigned provider networks to drive engagement and meet client needs.
• Educate and support providers in navigating UM processes, including prior authorizations, medical necessity reviews, and evidence-based care guidelines.
• Serve as a key liaison between providers and the UM team, ensuring clear communication, issue resolution, and ongoing support.
• Act as the in-market expert by managing implementation, education, and continuous engagement for referral benefits and workflows.
• Collaborate with internal teams to execute engagement plans, deliver provider education, and analyze data to identify opportunities for intervention and improvement.
• Serve as an in-market expert, build relationships with key stakeholders, and promote WellSky solutions.
• Provide regular updates on provider engagement performance, program feedback, and market insights to internal teams and clients.
• Partner with marketing and operational teams to create educational and promotional materials supporting provider engagement efforts.
• Monitor provider performance and engagement trends, analyzing UM-related data to identify opportunities for intervention, workflow optimization, and improved patient outcomes.
• Perform other job duties as assigned.

Qualifications

• At least 4-6 years relevant work experience.
• Bachelor's Degree or equivalent work experience.

Requirements

• Proven ability to engage, educate, and influence healthcare providers in a healthcare or relevant domain preferably in a UM or care management setting.
• Strong understanding of Utilization Management principles, payer-provider dynamics, and prior authorization workflows.
• Experience in provider education, network engagement, or compliance monitoring.
• Ability to analyze data to drive strategic engagement.
• Experience articulating scorecards, performance metrics, and provider outreach strategies.
• Experience in coaching and development of clinical programs to increase provider quality metrics.

Benefits

• Excellent medical with Rx, dental, and vision benefits.
• Mental Health support through EAP.
• Generous paid time off, plus 13 paid holidays.
• 100% vested 401(K) retirement plans.
• Educational assistance up to $2500 per year.