What are the responsibilities and job description for the Regional Market Manager position at PBACO Holding LLC?
Key Responsibilities:
The Regional Manager, Provider Engagement is responsible for developing and managing strategic relationships with providers and practice leaders within a designated region. This role plays a critical part in supporting provider performance, promoting alignment with value-based care objectives, and ensuring a strong provider experience within the ACO network. The Regional Manager acts as a trusted liaison between clinical teams, leadership, and network partners.
Provider Relationship Management
- Serve as the primary point of contact for contracted providers and clinical leadership within the ACO network
- Develop and execute provider engagement strategies to foster collaboration, trust, and accountability
- Lead provider onboarding and orientation to ACO programs, expectations, and performance metrics
- Conduct regular provider meetings, site visits, and feedback sessions to understand needs and concerns
- Support initiatives to improve documentation and coding accuracy, particularly HCC/risk adjustment
Performance & Quality Support
- Collaborate with analytics, population health, and care coordination teams to deliver actionable insights to practices
- Help practices understand and improve key metrics including quality performance, utilization, cost efficiency, and risk adjustment (e.g., HCC coding)
- Provide education and tools to support best practices in documentation, care coordination, and patient outcomes
- Identify gaps in performance and work collaboratively with internal teams and providers to implement improvement initiatives
Communication & Reporting
- Deliver clear and timely updates to providers on ACO initiatives, payer program requirements, and network-wide performance
- Track and report on provider engagement activities, trends, barriers, and improvement efforts within the region
- Elevate provider concerns or operational challenges to appropriate internal stakeholders for resolution
Supervisory Responsibilities:
Manage team of Provider Consultants
Qualifications
Education & Experience
- Bachelor’s degree in healthcare administration, public health, business, or related field required; Master’s degree a plus
- 5 years of experience in provider relations, practice management, clinical operations, or network development within a healthcare organization
- Experience working in value-based care environments, ACOs, or managed care preferred
- Strong understanding of population health, care coordination, and quality improvement strategies
Skills & Competencies
- Excellent interpersonal and communication skills with the ability to build rapport and influence stakeholders
- Ability to analyze performance data and translate into practical recommendations for clinical teams
- Strong organizational skills, with the ability to manage multiple priorities across practices and teams
- Self-motivated, results-oriented, and comfortable working in a fast-paced, matrixed environment
- Proficiency in Microsoft Office (Excel, PowerPoint, Word), and familiarity with data visualization/reporting tools (e.g., Tableau, Power BI)
Preferred Qualifications
- Clinical experience or background (e.g., RN, LPN, MA)
- Experience working with EHR systems, population health platforms, or healthcare analytics tools
- Familiarity with Medicare Shared Savings Program (MSSP), risk-based contracts, or other alternative payment models
Preferred Qualifications
- Clinical background (e.g., RN, NP, PA, MD) a plus
- Experience working with FQHCs, IPAs, or multi-specialty groups
- Familiarity with MACRA, MIPS, and CMS Innovation Center models
- Knowledge of population health platforms and EHR systems
Language Skills:
Ability to read and comprehend simple instructions, correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one situations to visitors, clients, physicians, healthcare entities, leadership and other employees of the organization.
Reasoning Ability:
Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions.
Computer Skills:
MS Office Productivity Tools (Word, Excel, Outlook, PowerPoint), SQL, Power BI, SSRS, relational databases and other related software/technology.
Other Skills and Abilities:
High accuracy and extreme confidentiality a MUST. Detailed oriented and very organized.
Physical Demands:
While performing the duties of this Job, the employee will have a combination of standing, sitting, bending and reaching. May work at a computer monitors for prolonged periods. The employee may lift and/or move up to 10 pounds.