Network Management Consultant - Provider Performance - Houston, TX
Core
Support HEDIS, STARS, and financial provider performance and contracting activities to ensure strategic provider coverage within an assigned territory.
Role type
Provider performance and contracting consultant
Builds
Provider contracts and performance improvement plans for physicians, physician groups, and hospitals
Domain
Healthcare / Managed Care
Deliverable
client delivery
Required skills
contract negotiation, provider relationship management, data analysis, action plan development, strategic coverage planning
Preferred skills
HEDIS and CMS STARs experience, health insurance knowledge, project management, financial/trend analysis, EMR and population health tools proficiency
Responsibilities
Develop and maintain strong provider relationships, deliver provider education and service, support complex hospital and physician contracting initiatives, leverage analytics to influence outcomes, develop and execute action plans for performance improvement
Seniority
Mid-level, hands-on IC