What are the responsibilities and job description for the Regional Director - Northeast position at PBACO Holding LLC?
About the Role
We are seeking a strategic, results-oriented Regional Director of Provider Engagement to own market-level performance across our Northeast region (CT, ME, MA, NH, NJ, NY, PA, RI, VT, DE, MD, DC). This is a senior leadership role with direct accountability for shared savings outcomes, quality improvement, utilization management, and provider adoption within Medicare Shared Savings Program (MSSP) and other value-based contracts.
The Regional Director leads a team of state-level Market Managers and Provider Consultants, translating organizational strategy into measurable, on-the-ground execution. The ideal candidate combines deep knowledge of value-based care models with strong people leadership and a data-driven mindset.
What You’ll Do
Regional Strategy & Market Ownership
- Own overall Northeast market performance across MSSP and other assigned value-based contracts.
- Translate enterprise Provider Engagement strategy into Northeast-specific execution plans.
- Maintain current, working knowledge of provider groups across the region, including performance standings, active initiatives, and engagement risks.
- Serve as the primary escalation owner for Northeast market performance issues.
Financial, Quality & Utilization Performance
- Drive shared savings results year-over-year across MSSP and other contracts.
- Partner cross-functionally with Quality, Data, Population Health, and Operations teams to identify performance gaps and implement corrective actions.
- Monitor utilization and readmission trends and ensure timely interventions when performance is at risk.
Team Leadership & Supervision
- Directly supervise state Market Managers and Provider Consultant Supervisors across the region.
- Hold Market Managers accountable to KPI attainment (90% target) and foster a culture of continuous improvement.
- Coach, develop, and manage Provider Consultants; implement performance improvement plans as needed.
- Review touch reports and provider engagement documentation; provide actionable, documented feedback.
Provider Engagement & Compliance
- Ensure consistent execution of provider engagement standards, documentation requirements, and follow-up expectations.
- Maintain accuracy in provider data and ensure audit readiness across the team.
- Ensure timely escalations and document risks, interventions, and follow-up actions related to quality, utilization, and financial performance.
- Ensure compliance with organizational, contractual, and regulatory requirements.
What Success Looks Like
- Year-over-year increase in Northeast region shared savings for MSSP and other value-based contracts.
- Northeast region average quality score increases by at least 1% annually.
- Post-Discharge Visit (PDV) completion rates meet or exceed established regional targets.
- App usage “acted on” percentage remains above 80% for at least 75% of tracked weeks.
- Care management tool utilization increases a minimum of 1% per quarter across all contracts.
- Market Manager KPI achievement at or above 90%.
- 98% adherence to escalation policy timelines.
- At least 50% of touch reports reviewed with documented value-add feedback.
Qualifications
Required
- Bachelor’s degree in Healthcare Administration, Business, Public Health, or a related field.
- 5 years of experience in provider engagement, healthcare operations, ACOs, or value-based care.
- Demonstrated experience leading teams and driving performance through KPIs.
- Strong working knowledge of MSSP and value-based reimbursement models.
- Proficiency with MS Office (Word, Excel, Outlook, PowerPoint), Power BI, and data reporting tools.
Preferred
- Master’s degree in a relevant field.
- Clinical background (RN, NP, PA, or MD).
- Experience working with FQHCs, IPAs, or multi-specialty groups.
- Familiarity with MSSP, Commercial, MIPS, and CMMI models.
- Knowledge of population health platforms and EHR systems.
- Experience with SQL, SSRS, and relational databases.
Key Competencies
- Market ownership and strategic execution
- Financial and quality performance management
- People leadership, coaching, and accountability
- Data-driven decision-making
- Provider relationship management
- Escalation and risk management
- High degree of professionalism, discretion, and confidentiality
Travel
Local travel is required. Overnight travel up to 1–2 times per month based on business needs.
Salary range may vary by location. Final compensation will be determined based on geographic market, experience, and qualifications.