Provider Improvement Analyst
Core
Overseeing and improving the performance of delegated partnerships programs and acting as the engagement lead for high-value strategic health partners.
Role type
Provider Engagement Specialist (Provider Delegation Performance)
Builds
Performance improvement plans, strategic engagement initiatives, and network performance support for delegated providers.
Domain
Healthcare / Managed Care / Provider Relations
Deliverable
client delivery
Required skills
Provider relations, provider contracting, managed care, value-based reimbursement oversight, performance tracking, program management, regulatory compliance (federal/state laws), population health techniques, data reporting, practice transformation support, policy evaluation.
Preferred skills
Master's degree, NCQA PCMH experience, Six Sigma certification, Project Management certification.
Technologies
Microsoft Outlook, Word, Excel.
Responsibilities
Manage end-to-end data collection and evaluation for performance measures; lead market performance and engagement strategic initiatives; develop and monitor performance improvement plans with providers; drive quality outcomes through Value Based Reimbursement agreements; lead Joint Operating Committees (JOCs) to present provider performance data; provide on-site practice transformation support and education; ensure regulatory compliance and accreditation standards; generate monthly and quarterly performance and administrative reports.
Seniority
Mid-level, hands-on IC