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Betsy Roberts

@betsyroberts

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Provider Engagement Manager translating healthcare performance data into actionable guidance for better outcomes.

United States

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What I'm looking for

I’m looking for a remote role where I can lead provider engagement across multi-state networks, turn performance metrics into clear actions, and partner cross-functionally to reduce denials, improve authorization efficiency, and strengthen provider outcomes.

I’m a Provider Engagement Manager known for managing high-complexity provider relationships across multi-state markets. I translate detailed performance data and metrics into clear, actionable guidance that empowers providers to improve outcomes, while keeping them informed, supported, and positioned for success.

At Evolent Health, I served as primary relationship owner for oncology, cardiology, and imaging providers, delivering structured monthly and quarterly performance reviews that drove measurable results—+8% portal adoption, +6% auto-approval rates, and 1–7% reductions in expedited requests. I also prepared comprehensive quarterly denial reports and leveraged Copilot to analyze denial patterns and develop action plans, helping providers reduce denial rates to below 30%.

I conduct 50+ provider education sessions across onboarding, re-education, and workflow training to equip teams to meet performance metrics and operational goals. I proactively partner with IT, Operations, and UM to resolve escalated data and clinical-related inquiries, reducing rework and minimizing delays to the prior authorization process and patient care, while maintaining audit-ready CRM documentation and compliance across networks.

Before my current role, I advanced through provider services and network leadership, including Sr. Provider Services Representative at Passport by Molina Healthcare and Sr. Provider Network Manager at Evolent Health. Earlier, I built and administered provider networks as an AllyAlign Health Network Development Rep / Account Manager (contracting across multiple Medicare Advantage lines), and I began my career supporting national provider data and compliance as an Express Scripts Provider Network Analyst and Credentialing Coordinator.

Experience

Work history, roles, and key accomplishments

Provider Engagement Manager

Evolent Health

Jan 2022 - Dec 2025 (3 years 11 months)

Owned multi-state provider relationships for oncology, cardiology, and imaging providers, resolving complex clinical/data inquiries to support better patient care. Drove measurable performance improvements including +8% portal adoption, +6% auto-approval rates, 1–7% reductions in expedited requests, and reduced denial rates to below 30%.

Provider Relations Provider Education Portal Adoption

Sr Provider Services Rep

Passport by Molina Healthcare

Dec 2020 - Feb 2022 (1 year 2 months)

Served as the primary liaison between providers and DMS, responding to escalated issues within 24 hours and exceeding service-level expectations. Built tracking systems to streamline provider outreach and documentation collection, improving data accuracy and workflow completion.

Provider Services SLA Management Medicaid Operations Tracking Systems Documentation Management

Sr Provider Network Manager

Evolent Health

Nov 2019 - Nov 2020 (1 year)

Managed statewide cardiology provider relationships by delivering education and operational support to improve readiness for performance metrics and clinical requirements. Resolved complex provider record issues and system updates to strengthen authorization approvals and data integrity.

Provider Network Management Provider Education Performance Metrics Authorization Management Data Integrity

Network Account Manager

AllyAlign Health

Aug 2017 - Sep 2019 (2 years 1 month)

Supported expansion of Medicare Advantage (I-SNP/C-SNP/D-SNP) networks by coordinating provider recruitment and negotiating compliant contract terms across product lines. Collaborated with clients on network strategy reviews and contracting execution to support new benefits.

Provider Recruitment Contract Negotiation Medicare Advantage Regulatory Compliance Network Strategy

Network Development Rep

AllyAlign Health

Feb 2016 - Apr 2017 (1 year 2 months)

Recruited and contracted specialty physicians, hospitals, and ancillary providers across five states to expand Medicare Advantage networks and address network adequacy gaps. Managed full-cycle contract administration and performed market analysis to identify coverage needs and targeted recruitment opportunities.

Provider Contracting Medicare Advantage Market Analysis Contract Administration Compliance Review Stakeholder Management

Sr Provider Services Representative

Kentucky Health Cooperative

Jul 2013 - Feb 2016 (2 years 7 months)

Served as the point of contact during launch of an ACA commercial health plan, building provider relationships across 15 Kentucky counties and bordering regions. Grew the provider network from zero to over 1,400 providers through targeted recruitment and high-value outreach while maintaining HIPAA and audit-ready documentation.

Provider Relations Network & Growth Commercial Health Plans HIPAA

Provider Network Analyst

Express Scripts

Jul 2010 - Jul 2013 (3 years)

Expanded the national provider network from 100 to 1,800+ locations by recruiting home health, infusion pharmacy, DME, and related provider types. Managed pricing data loads and contract/pricing documentation while receiving recognition for quality and customer service.

Network Analysis Provider Recruitment Pricing Data Management Infusion Pharmacy Customer Service

Project Coordinator

Express Scripts

Aug 2009 - Jul 2010 (11 months)

Resolved daily operational issues with cross-functional teams to improve response times and reduce workflow delays. Partnered with IT to streamline referral databases and maintain accurate data to support faster patient support and improved operational efficiency.

Project Coordination Cross Functional Collaboration Workflow Optimization Process Improvement Response Time Management

Credentialing Coordinator

Express Scripts

Aug 2007 - Jul 2009 (1 year 11 months)

Maintained NCQA and URAC compliance by managing credentialing files and ensuring complete, audit-ready documentation. Improved credentialing turnaround times by streamlining the application and committee review process to enable timely approvals.

Credentialing NCQA URAC Committee Review Coordination