Provider Network Performance Manager

🕒 Agosto 18

🏖️ New Jersey – Remoto

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💵 $60.000 - $115.000 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👔 Gerente

👻 Score fantasma 0%

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Logo of Devoted Health

Devoted Health

1001 - 5000 funcionários

Fundada em 2017

🏥 Saúde

⚕️ Seguro de Saúde

🧘 Bem-estar

Healthcare • Healthcare Insurance • Wellness

A Devoted Health é uma empresa de saúde que oferece planos Medicare Advantage projetados para fornecer cobertura de saúde abrangente com benefícios adicionais como cuidados dentários, óculos, associações a academias e medicamentos prescritos a preços competitivos. A empresa enfatiza o suporte e serviço ao membro, garantindo que os clientes possam navegar facilmente por seus benefícios e acessar os serviços de saúde necessários. A Devoted Health está comprometida em ajudar os clientes a economizar dinheiro e melhorar sua saúde e bem-estar por meio de um pacote completo de benefícios e suporte.

Descrição

• Drive provider performance across cost, quality, access, and key network metrics • Identify performance gaps, root causes, and opportunities for improvement • Develop and execute targeted provider performance improvement plans • Monitor results and adjust strategies to drive sustained improvement • Serve as a primary performance partner for assigned physicians, medical groups, health systems, and other providers • Lead regular provider performance reviews and Joint Operating Committees (JOCs) • Build provider relationships while creating accountability for performance expectations and outcomes • Partner with providers to resolve performance issues and remove barriers to improvement • Analyze financial, operational, quality, and provider performance data • Leverage reporting systems, dashboards, and AI-enabled tools to generate insights • Translate complex data into clear recommendations and actionable strategies • Provide leadership with visibility into performance trends, risks, and opportunities • Support contract negotiations and renegotiations, where applicable • Apply fee-for-service, value-based, and risk-based models to support improvements in cost and quality • Evaluate provider and network opportunities through a performance lens • Partner cross-functionally to improve network efficiency, quality, access, and regulatory compliance • Travel approximately 30–40% within the assigned market for provider meetings, relationship building, and market presence

🎯 Requisitos

• Must be located in New Jersey • 5+ years of experience in managed care, a health plan, or a similar healthcare environment • 5+ years of direct provider-facing experience • Demonstrated experience improving provider performance across cost and/or quality metrics • Strong analytical skills with the ability to translate data into action • Strong provider relationship management, communication, and influencing skills • Ability to work independently, solve complex problems, and drive results • Experience negotiating provider contracts, including physician groups and/or health systems • Experience with value-based or risk-based payment models • Experience in provider performance, network optimization, or healthcare analytics • Ability to travel approximately 30–40% within the assigned market

🏖️ Benefícios

• Employer sponsored health, dental and vision plan with low or no premium • Generous paid time off • $100 monthly mobile or internet stipend • Stock options for all employees • Bonus eligibility for all roles excluding Director and above • 401K program • Parental leave program • Total rewards package for full time employees

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