A health services organization in New York City is currently seeking an experienced professional to join their staff as their new Director of Provider Engagement.
In this role, the Director of Provider Engagement will be responsible for to developing and maximizing improved alignment, driving high performance and providing world-class engagement experience with the highest profile providers for the organization.
Responsibilities :
The Director of Provider Engagement will be responsible for :
- Lead the Provider Engagement team under the Vice President of Provider Network Operations
- Develop and execute strategies to enhance alignment and performance with key providers
- Drive market-level projects to optimize quality, risk adjustment, utilization management, financial performance, and membership growth
- Build strategic partnerships aligned with business goals through Provider Engagement functions management
- Create and formalize Provider Engagement strategy, including Quarterly Business Review (QBR) processes
- Analyze provider group performance data to identify improvement opportunities and focus areas
- Collaborate cross-functionally with Quality Management, Risk Adjustment, Clinical Services, and Sales to monitor and enhance performance trends
- Align partnership goals with providers' business strategies, ensuring mutual understanding and shared objectives
- Conduct Quarterly Business Reviews (QBR) covering financial, quality, utilization, and membership metrics
- Generate executive-level monthly reports on Provider Engagement activities, performance, and goal progress
- Maintain monthly executive reports highlighting key provider performance metrics and initiative progress
Qualifications :
- Associate's Degree required; Bachelor's degree or equivalent combination of education, training, and a minimum of 10 years of relevant healthcare industry experience in provider network management and value-based environments
- 5-7 years of relevant healthcare industry experience in provider network management and value-based environments
- Strong background in managed care, preferably with experience in network management and value-based roles
- Excellent healthcare and financial data analysis skills required
- Knowledge of IPAs, large provider groups, hospital systems, and diverse communities necessary for targeting providers serving various demographics
- Ability to interpret contractual language and effectively communicate messages to clients and customers through written and verbal communication
- Experience in facilitating and / or negotiating contractual arrangements
Desired Skills :
- Master of Public Administration (MPA) or Master of Public Health (MPH) degree
- Supervisory or team management experience
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