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Provider Engagement Specialist

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POST DATE 9/16/2016
END DATE 10/20/2016

Tufts Health Plan Watertown, MA

Watertown, MA
AJE Ref #
Job Classification
Full Time
Job Type
Company Ref #
Mid-Career (2 - 15 years)
Bachelors Degree


The Provider Engagement Specialist is responsible for reporting clinical and analytical data and support services available to Tufts Health Plan's commercial providers who have accepted meaningful risk in their reimbursement contracts with THP. Under the direction of the Provider Engagement Manager, the Specialist will work with a cross-functional team to help coordinate production and delivery of analytical presentations to risk-based providers to help them identify and address opportunities. This individual will contribute to the design and execution of performance analysis. The Provider Engagement Specialist will assist in strategically evaluating and improving current reporting.
The Provider Engagement Specialist will support the maintenance and improvement of monthly provider data file production and distribution. In addition, this individual will be responsible for supporting departmental and corporate priority projects through strategic input and project management.


Responsible for delivering quarterly data and strategy presentations to risk-based providers to help identify and address opportunities for improvement
Assist in the management of monthly provider data file production, issue resolution and coordination of weekly team meeting
Assist in the coordination of a cross-functional team charged with the following objectives:
*Produce standard reporting and analytics for risk-based providers
*Generate hypotheses for provider medical cost trends and quality performance
*Initiate analyses designed to test trends, understand performance variability (at a group and physician level), and suggest opportunities for performance improvement
*Design and execute performance analysis when necessary
Assist in the design and production of presentations for risk-based providers illustrating conclusions to analyses and highlighting opportunities for cost/quality performance improvement
Assist manager and other team members in assessing current analysis for efficiency and relevance, proposing new analysis and revamping standard provider engagement content
Coordinate weekly meetings of cross-functional team, create agenda, draft notes, and track follow-up assignments
Assist in the project management and strategic planning of departmental and corporate priority projects.

EDUCATION: (Minimum education & certifications required)
Undergraduate degree required, master's degree preferred.

EXPERIENCE: (Years of experience)
3-5 years related experience in a managed health care environment, with knowledge of the health care market and the needs/concerns of health care providers.

SKILL REQUIREMENTS: (Include interpersonal skills)
--Excellent written and oral communication skills
--Comfort with developing and delivering presentations for internal teams and external audiences
--Strong ability to manage/organize project teams
--Ability to prioritize and work on multiple projects simultaneously
--Ability to develop productive working relationships with colleagues in other departments
--Ability to communicate effectively with internal staff at all levels
--Excellent interpersonal skills
--Strong analytic skills and problem-solving ability
--Excellent computer skills, including expertise in Microsoft Powerpoint and Excel

WORKING CONDITIONS AND ADDITIONAL REQUIREMENTS (include special requirements, e.g., lifting, travel, overtime)
Business professional environment. Regular travel to local offsite locations.

CONFIDENTIAL DATA: All information (written, verbal, electronic, etc.) that an employee encounters while working at Tufts Health Plan is considered confidential. Exposed to and required to deal with highly confidential and sensitive material and must adhere to corporate compliance policy, department guidelines/policies and all applicable laws and regulations at all times.

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled


Founded in 1979 as a non-profit health maintenance organization (HMO), Tufts Health Plan is one the country's largest HMO offering a full array of healthcare coverage options to individual consumers and employer groups. Tufts Health Plan has received high marks for its quality from a variety of third parties including U.S News & World Report and Newsweek.