Manager, Network Management - Provider Performance - Houston, TX
Core
Manage daily activities and implement strategies to improve provider HEDIS, STARS, risk adjustment, and financial performance while leading provider recruitment and contracting efforts for physicians, physician groups, and facilities.
Role type
Manager, Provider Performance & Contracting
Builds
Provider contracts and strategic coverage within assigned territories
Domain
Health Insurance / Managed Care
Deliverable
client delivery
Required skills
provider contracting, HEDIS, STARS, risk adjustment, team leadership, negotiation, relationship building, data analysis, project management
Preferred skills
financial/trend analysis, advanced Excel, health insurance product design
Technologies
claims/processing systems, Microsoft Office, Excel
Responsibilities
Develop and negotiate contracts with physicians and health systems, lead and mentor a team of Provider Performance Network Operations Consultants, ensure strategic coverage within the assigned territory, provide ongoing provider education and service, measure outcomes and adjust strategies to achieve client goals in a value-based care environment
Seniority
Manager, hands-on leadership
