Full-Time

Provider Engagement Specialist

Posted on 9/24/2025

Lumeris

Lumeris

1,001-5,000 employees

Value-based care management via PHSO platform

Compensation Overview

$72.8k - $97.4k/yr

+ Performance-based incentive + Equity

Concord, NH, USA

In Person

Category
Consulting (2)
,
Requirements
  • Bachelor's degree or equivalent
  • 3+ years of client-facing experience within the healthcare domain or the knowledge, skills, and abilities to succeed in the role
  • Experience working with physician practices including; provider relations, provider education, practice transformation and/or practice management
  • Skilled at change management
  • Demonstrated subject matter expertise in any of the following areas: Medicare advantage, Medicare Shared Savings Program (MSSP), managed care regulations, quality reporting, care management, population management, ACO strategy implementation and operations, and supporting providers in risk based contracts
  • Strategic and entrepreneurial outlook with strong collaborations skills
  • Ability to guide complex client interactions at C-level
  • Ability to operate in a fast-paced and dynamic environment
  • Team player, excellent communication skills
  • Demonstrated understanding of healthcare metrics and use of analytical skills
  • Extensive knowledge of the U.S. healthcare system
  • Strong client-facing skills
  • Solid presentation skills
Responsibilities
  • Responsible for practice transformation including practice observations, review of findings, best practice recommendations related to a practice's readiness for value-based care
  • Coaches on pre-visit planning and closure of gaps in care
  • Provides high-risk patient follow-up (after inpatient discharge, after ER visit, for complex cases)
  • Enhances access to care and referral network optimization
  • Identifies pharmacy management opportunities (promoting generics, medication adherence, step therapy)
  • Ensures comprehensive and accurate documentation and coding of risk-adjusted patient populations to ensure appropriate risk score and revenue capture
  • Develops and implements initiatives to improve performance against value-based contract metrics
  • Establishes strong personal relationships with Accountable Care Teams: physicians, nurses, administrative staff and management
  • Develops and delivers programs, training, and adoption to client
  • Responsible for deliverables of client engagements, including project timelines and logistics
  • Provides subject-matter expertise in program development and solution packaging
  • Keeps abreast of current industry, market, and policy landscape

Lumeris provides value-based care managed services for health systems and physician groups, delivering technology, services, and risk management to move care from fee-for-service to value-based models. Its Population Health Services Organization (PHSO) combines an AI-powered platform called Tom with workflows and expert support to coordinate care, schedule screenings, and manage chronic diseases across patient populations. The company differentiates itself through risk-sharing partnerships with providers and payers, leveraging Essence Healthcare’s proven value-based model to pursue both quality and cost-efficiency. Its goal is to expand value-based care adoption by forming broader risk-based partnerships that improve patient outcomes while delivering predictable, efficient care delivery.

Company Size

1,001-5,000

Company Stage

Late Stage VC

Total Funding

$507M

Headquarters

Maryland Heights, Missouri

Founded

2001

Simplify Jobs

Simplify's Take

What believers are saying

  • Hackensack Meridian expansion to Traditional Medicare yields $40M savings and 87.27% CMS quality score in 2024.
  • Native audio for Tom using Gemini reduces latency, addressing 90,000-physician shortage by 2030.
  • $100M equity raise in April 2024 fuels national scaling of AI-driven population health management.

What critics are saying

  • UnitedHealth's $4.2B Agilon Health acquisition consolidates 2,800 physicians, extinguishing Lumeris partnerships in 6-12 months.
  • CMS 2.69% Medicare Advantage cut for 2027 slashes margins, forcing health system exits in 12-18 months.
  • OpenAI-Kaiser GPT-5o audio agents triage 12M members, obsoleting Tom platform in 18-24 months.

What makes Lumeris unique

  • Lumeris delivers Primary Care as a Service with AI platform Tom, embedding speech-to-speech interactions into workflows.
  • PHSO model aligns payers, providers, and patients, managing $13B medical spend across 1M patients.
  • 20-year track record from Essence Healthcare proves value-based care with 4.5+ star Medicare Advantage plans.

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Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

Health Savings Account/Flexible Spending Account

Unlimited Paid Time Off

Flexible Work Hours

Paid Vacation

Paid Sick Leave

Paid Holidays

Sabbatical Leave

Hybrid Work Options

401(k) Company Match

Employee Assistance Program

Employee Resource Groups

Employee Discount Program

Learning and Development Opportunities

Growth & Insights and Company News

Headcount

6 month growth

1%

1 year growth

1%

2 year growth

2%
PR Newswire
Mar 18th, 2026
Lumeris launches Ask Tom, giving health leaders conversational AI access to enterprise data

Lumeris has launched Ask Tom, an AI-powered analytics capability that gives health system leaders conversational access to enterprise data through its Tom Primary Care as a Service platform. The tool allows users to query complex healthcare data in plain English and receive instant answers, visualisations and recommendations. Ask Tom aggregates data from clinical, claims, pharmacy and social determinants sources to create a comprehensive view of patients and populations. The platform features agentic capabilities that continuously monitor enterprise data, detect anomalies and surface improvement opportunities. The launch addresses mounting pressure in US primary care, where nearly 100 million adults lack access and a shortage of 90,000 physicians is projected over the next decade. Ask Tom is currently available in limited preview, with broader availability planned for 2026.

PR Newswire
Jan 27th, 2026
Hackensack Meridian Health and Lumeris expand value-based care partnership to Traditional Medicare after saving $40M

Lumeris and Hackensack Meridian Health have expanded their value-based care partnership to include Traditional Medicare through the Medicare Shared Savings Program ACO. The collaboration builds on their existing work with commercial and Medicare Advantage patients across HMH's Clinically Integrated Network. The HMH ACO comprises over 700 doctors serving approximately 46,200 patients. In 2024, the organisation achieved $40 million in healthcare savings with an 87.27% quality score from CMS, earning over $18 million in shared savings. Previous HMH ACO groups saved more than $247 million between 2012 and 2021. Lumeris will support the programme with its AI-powered Tom platform, enabling performance tracking and workflow management. The expansion aims to improve care coordination whilst reducing avoidable utilisation and administrative burden for Medicare beneficiaries across New Jersey.

The Health
Dec 18th, 2024
Lumeris secures $100M for expansion

Lumeris, a value-based care strategy company, secured $100 million in equity capital led by Deerfield Management, with participation from Endeavor Health and others. The funds will support expanding provider partnerships. Lumeris has a strong track record, including a five-star Medicare Advantage plan. Recent partnerships include Stanford Health Care and Integrated Physician Network. The company has also expanded its leadership team with key appointments.

PR Newswire
Apr 22nd, 2024
Lumeris Completes $100M Equity Growth Capital Investment Round

/PRNewswire/ -- St. Louis-based, privately held Lumeris announced the completion of a $100M equity capital raise. The funding round was led by Deerfield...

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