Provider Network Performance Manager

This is a fully remote position, open to applicants in New York.

📋 Description

• Manage performance metrics for designated providers, focusing on cost, quality, access, and essential network indicators.

• Identify performance deficiencies, underlying causes, and areas for enhancement.

• Create and implement specific performance improvement strategies for providers.

• Track outcomes and modify approaches to ensure ongoing improvement.

• Act as the primary performance liaison for assigned physicians, medical groups, health systems, and other providers.

• Facilitate regular performance evaluations and Joint Operating Committees (JOCs) with providers.

• Cultivate strong relationships while establishing clear accountability for performance expectations and results.

• Collaborate with providers to address performance challenges and eliminate obstacles to progress.

• Analyze financial, operational, quality, and provider performance data to uncover trends and opportunities.

• Utilize reporting systems, dashboards, and AI-driven tools to derive insights.

• Simplify complex data into straightforward recommendations and actionable plans.

• Provide leadership with insights into performance trends, risks, and opportunities.

• Assist in contract negotiations and renegotiations, as necessary, to align provider incentives with performance objectives.

• Apply fee-for-service, value-based, and risk-based models to enhance cost and quality.

• Assess provider and network opportunities from a performance perspective.

• Collaborate across functions to enhance network efficiency, quality, access, and compliance with regulations.

• Travel approximately 30–40% within the designated market for provider meetings, relationship development, and market engagement.

⛳️ Requirements

• Must reside in NYC.

• Over 5 years of experience in managed care, a health plan, or a comparable healthcare setting.

• More than 5 years of direct experience in provider-facing roles.

• Proven track record of enhancing provider performance in terms of cost and/or quality metrics.

• Strong analytical abilities with the capability to convert data into actionable steps.

• Excellent provider relationship management, communication, and influencing skills.

• Ability to work autonomously, resolve complex challenges, and achieve outcomes.

• Experience in negotiating provider contracts, including those with physician groups and/or health systems (preferred).

• Familiarity with value-based or risk-based payment models (preferred).

• Experience in provider performance, network optimization, or healthcare analytics (preferred).

🏝️ Benefits

• Employer-sponsored health, dental, and vision plans with little to no premium.

• Generous paid time off.

• Monthly stipend of $100 for mobile or internet expenses.

• Stock options available for all employees.

• Bonus eligibility for all positions excluding Director and above.

• Commission eligibility for Sales roles.

• Parental leave program.

• 401K program.