Provider Performance and Engagement Manager (Hybrid)

SummaryThis role is responsible for strengthening strategic partnerships between the health plan and contracted provider networks throughout Queens. The position focuses on improving provider performance, advancing value based care initiatives, supporting clinical and operational outcomes, and ensuring providers have the guidance, data, and resources needed to deliver high quality care to members.Key ResponsibilitiesConduct regular in person provider visits to review performance metrics and identify opportunities to improve patient careLead value based care initiatives by educating and supporting providers on performance based programsUse data analytics to evaluate provider performance and deliver actionable recommendationsBuild and maintain strong relationships with internal teams and external provider leadership including C suite partnersResolve provider issues related to claims, operations, and policy while ensuring long term process improvementsPrepare and present detailed performance reports including HBR analysis for leadership and Joint Operating Committee meetingsQualificationsBachelor’s degree in a related field or equivalent experienceMaster’s degree in Public Health (MOH), Health Administration (MHA), or Business Administration (MBA) preferredFive or more years of experience in managed care, provider relations, quality improvement, utilization management, or clinical operationsExperience in project management within a medical group, IPA, or health planProven ability to influence executive leadership and drive performance, innovation, member outcomes, and provider retentionStrong ability to synthesize complex issues across multiple organizational levelsHigh proficiency in HEDIS and quality measures, cost, and utilization management

Salary : $86,000 - $154,700