Provider Network Performance Manager

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $60k - $115k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 0%

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Devoted Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2017

🏥 Healthcare

⚕️ Healthcare Insurance

🧘 Wellness

Healthcare • Healthcare Insurance • Wellness

Devoted Health is a healthcare company that offers Medicare Advantage plans designed to provide comprehensive health coverage with added benefits like dental, eyewear, gym memberships, and prescription drugs at competitive rates. The company emphasizes member support and service, ensuring that clients can easily navigate their benefits and access needed healthcare services. Devoted Health is committed to helping customers save money and enhance their health and wellness through a complete package of benefits and support.

📋 Description

• Own performance management for assigned providers 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 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 to identify trends and opportunities • 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, to align provider incentives with performance goals • 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

🎯 Requirements

• MUST BE LOCATED IN GA • 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 (desired) • Experience with value-based or risk-based payment models (desired) • Experience in provider performance, network optimization, or healthcare analytics (desired)

🏖️ Benefits

• 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 • Commission eligibility for Sales roles • Parental leave program • 401K program