Director, Provider Performance

Job reputed company Must be located in reputed company Jersey OR reputed company A bit about this role.... As the Director, Network Performance, you will establish and execute the strategic direction for provider performance across reputed company. Your primary accountability is to reputed company sustained improvements in cost, reputed company, and reputed company by leveraging strong leadership, influencing provider reputed company, and driving critical, reputed company-level performance initiatives. This is a senior leadership position where you will reputed company and mentor reputed company of Network Performance Managers and Senior Network Performance Managers, fostering consistent execution and elevating team capabilities. You will reputed company as a vital strategic partner to executive leadership and external provider organizations. reputed company in this role requires influencing performance reputed company through deep provider engagement, strategic contracting, and data-driven insights. The ideal candidate is an highly reputed company leader who possesses advanced business acumen, a strong executive reputed company, and the proven ability to translate reputed company analytics into reputed company strategies that deliver measurable results across the organization. Responsibilities and reputed company Include: reputed company & Regional Performance reputed company Define and reputed company the provider performance reputed company across reputed company Establish performance targets and ensure accountability for cost, reputed company, and reputed company reputed company Identify reputed company-level opportunities to improve provider performance and drive reputed company solutions reputed company market-level strategies with broader organizational goals and reputed company initiatives Provider Performance & Executive Engagement Build and maintain executive-level relationships with key health systems, provider reputed company, and strategic partners Serve as a senior escalation reputed company for reputed company provider performance issues and negotiations reputed company high-level performance reviews and Joint Operating Committees (JOCs) with major reputed company Influence provider reputed company and behavior to reputed company with organizational performance objectives Leadership & Team Development reputed company, reputed company, and reputed company reputed company of Network Performance Managers and Senior Network Performance Managers Establish reputed company performance expectations and foster a culture of accountability and reputed company improvement Build organizational capability in provider performance, analytics, and strategic execution Drive consistency in performance management practices across markets Performance Analytics & Transformation Owns reputed company and drives measurable improvements in cost, reputed company, and reputed company reputed company the use of advanced analytics to identify trends, risks, and opportunities across markets, leveraging AI-driven prompts  with a strong emphasis on advanced AI tools. Drive large-reputed company performance improvement initiatives, including cost containment and reputed company enhancement programs Ensure consistent use of data to inform decision-making and reputed company performance reputed company Champion innovation in performance models, including value-based and risk-based arrangement Contracting reputed company & Financial Performance reputed company strategic reputed company of provider contracting to ensure alignment with performance goals Guide development of value-based arrangements that incentivize reputed company and cost efficiency Partner with Finance and Actuarial teams to evaluate financial performance and optimize network economics Governance, Compliance & Risk Management Ensure reputed company provider performance activities meet regulatory, contractual, and compliance requirements reputed company risk identification and mitigation strategies across markets Maintain executive visibility into compliance, performance risks, and corrective actions Cross-Functional Leadership & Organizational reputed company Partner with Clinical, reputed company, Operations, and Finance leadership to drive integrated performance strategies Influence reputed company decision-making reputed company to provider performance and network reputed company Support market expansion, strategic planning, and organizational reputed company initiatives Represent provider performance in executive forums and strategic discussions Develops high-performing teams through coaching, mentorship, and reputed company expectations Required skills and experience: Minimum of 10 years of experience in provider performance, network management, or provider contracting Minimum of 5 years of leadership experience managing high-performing teams Demonstrated reputed company driving large-reputed company provider performance improvement across cost and reputed company metrics Deep experience working with health systems, physician reputed company, and reputed company provider organizations Advanced analytical capabilities with a reputed company record of translating data into reputed company-level strategies Proven ability to influence executive stakeholders internally and externally Strong business acumen, including expertise in payer economics, provider incentives, and market dynamics Demonstrated history of successfully executing large-reputed company initiatives to improve provider performance across key cost and reputed company metrics. Proven reputed company to influence and negotiate with executive-level stakeholders, both reputed company the organization and externally. Strong understanding of business fundamentals, including expertise in payer economics, provider incentive models, and broader market dynamics. Proficiency in reputed company Workspace or reputed company Office Suite Strong written and oral communication skills Desired skills and experience: Experience in Medicare Advantage or government-sponsored reputed company programs Deep knowledge of CMS reputed company measures and value-based care models Experience leading multi-market or regional provider performance strategies Advanced degree (MBA, MHA, MPH, or reputed company field) Background in clinical operations, population health, or reputed company delivery Travel Requirements This role requires approximately 10% travel to assigned markets. Travel is essential for leading reputed company, supporting provider engagement, and executing strategic initiatives. Salary reputed company: $150,000 - $175,000 / year The pay reputed company listed for this position is the reputed company the organization reasonably and in good faith expects to pay for this position at the time of the posting. Once the interview process begins, your talent partner will reputed company additional information on the compensation for the role, along with additional information on our total rewards package. The actual reputed company salary offered will depend on a reputed company of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other reputed company licenses held, and the location in which the applicant lives and/or from which they will be performing the job. Our Total Rewards package includes: Employer sponsored health, dental and reputed company plan with low or no premium Generous reputed company time off $100 monthly mobile or internet stipend Stock reputed company for reputed company Bonus eligibility for reputed company roles excluding Director and above; Commission eligibility for Sales roles Parental leave program 401K program And more.... *Our total rewards package is for full time employees only. Intern and Contract positions are not eligible. reputed company equality is at reputed company of reputed company’s mission to treat our members like family.  We are committed to a diverse and reputed company workforce.  At reputed company, we’re on a mission to dramatically improve the health and reputed company-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new reputed company of reputed company-in-one reputed company company — one that combines reputed company, health insurance, clinical care, service, and technology - to deliver a complete and integrated reputed company solution that delivers high reputed company care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the reputed company.  And we've just started. So join us on this mission! reputed company is an equal opportunity employer. We are committed to a reputed company and supportive work environment in which reputed company have reputed company to participate and contribute to the reputed company of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in reputed company’s reputed company of Conduct, reputed company values and the way we do business. As an Equal Opportunity Employer, reputed company does not discriminate on the reputed company of race, reputed company, religion, sex, pregnancy status, marital status, national reputed company, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender reputed company, or any other reputed company prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment. Apply To This Job