Director - Strategic Provider Partnerships
September 15
Description
• Lead provider and health plan strategy related to performance improvement on cost, quality, coding and member outreach and engagement. • Responsible for ongoing review of performance reporting and data, interpreting and prioritizing results. • Utilize tools and resources to identify performance insights; work with health plan and provider functional leadership to present results and recommend actions to providers. • Manage provider performance in all levels of value-based agreements, including quality & utilization pay for performance and risk contracts. • Develop provider performance improvement strategy at the plan and provider levels. • Analyze and interpret cost and quality data to determine performance insights and prioritize provider actions. • Facilitate joint operating committee (JOC) performance discussions and work cross-functionally to build consensus on priorities and actions to improve performance. • Present financial, medical cost and quality performance data to provider leadership. • Support value-based contract negotiations through the contract value and support model. • Provide high-level recommendations to providers and health plan leadership regarding opportunities to optimize clinical workflow to increase member outreach and care coordination. • Understand member population and provider variation by line of business to most effectively support providers with performance improvement. • Develop proficiency in tools and value based contracting and educate providers on the use of tools and interpretation of data.
Requirements
• Bachelor’s Degree in Healthcare Administration, Business Administration, or similar field • Master’s degree preferred • 7+ years of experience in managed care, value-based contracting, or clinical experience
Benefits
• competitive pay • health insurance • 401K and stock purchase plans • tuition reimbursement • paid time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules
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