Manager, Network Performance

Position Overview

• Location Type:
• Job Type: Full time
• Salary:

Become a part of our caring community and help us put health first. As the Manager of Network Performance, you will lead a team of Network Performance Professionals dedicated to improving provider performance and enhancing Stars ratings. Your role is pivotal in fostering a collaborative and supportive environment where your team can thrive. By building and maintaining strong relationships with assigned physician groups, your team will implement strategies and tactics that elevate network performance and increase plan quality. This role offers a unique opportunity to leverage your expertise in healthcare provider relations to influence operational decisions and support the overall success of the organization. You will be responsible for guiding, mentoring, and developing your team to achieve their full potential, ensuring that they are equipped with the knowledge and tools necessary to excel in their roles.

Key Responsibilities

• Team Leadership: Lead a team of provider-facing direct reports, guiding them in their efforts to improve provider performance.
• CMS Program Expertise: Serve as the expert on CMS Stars program, HEDIS, CAHPS, and HOS, providing guidance and support to the team.
• Provider Solutions: Build and maintain strong relationships with provider practices, leading the team's discussions to find and implement improvement opportunities, develop workflows, and monitor outcomes while focusing on solutions that enhance provider engagement.
• Performance Metrics: Inform and lead the team based on enterprise, regional, and departmental KPIs and OKRs, ensuring alignment with organizational goals and objectives.
• Cross-Departmental Collaboration: Partner with other departments to advance performance in Provider Engagement, Stars Improvement, MRA, Interoperability, Clinical, Corporate Partners, and Provider Contracting to improve provider/member engagement. Leads interdepartmental and team strategy meetings.
• Data Driven-Insights: Ingest data from various sources, analyze it, and inform the team and leadership of learnings.
• Educational Initiatives: Create data-supported, focused education to drive team tactics and improve performance.
• Solution Focus: Direct the team's focus toward solutions that maximize provider abilities to engage effectively.
• Leadership Decisions: Own decisions related to people leadership, resources, strategic planning, and tactical operations for the team.
• Performance Review: Review and communicate performance results of the team and initiatives.
• Culture and Engagement: Articulate and model desired culture attributes, actively supporting team engagement, performance, well-being improvement plans, and team activities.

Use your skills to make an impact.

Required Qualifications

• Bachelor’s Degree in Business, Finance, Healthcare, or a related field, or equivalent experience.
• Prior Medicare experience & understanding of value-based care model.
• Knowledge of HEDIS/Stars and CMS quality measures.
• Proficiency in analyzing and interpreting healthcare data and trends.
• Demonstrated capability with leading, coaching, and developing associates formally or informally (training, SME, etc).
• Strong communication and presentation skills, both verbal and written, with experience presenting to internal and external customers, including high-level leadership.
• Focus on process and quality improvement, with an understanding of metrics, trends, and the ability to identify gaps in care.
• Comprehensive knowledge of all Microsoft Office applications, including Word, Excel, and PowerPoint.
• Must be able to work according to Mountain Time Zone and/or Pacific Time Zone hours.

Preferred Qualifications

• Master’s Degree in Business, Finance, Health Care/Administration, Nursing, or a related field.
• Progressive management experience, leading and developing others.
• Progressive experience in the health solutions industry, particularly with interoperability.
• Prior managed care or Medicaid experience.
• Background work