Sr. Mgr. Network Performance

 Posted 2 months ago
     
5-10 years experience
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AI Summary

The Senior Manager of Network Performance analyzes clinical and financial data to drive performance improvements and cost-efficiency within value-based care programs. They partner with medical directors to engage providers, manage onboarding, and ensure alignment with program goals and contractual requirements.

ESSENTIAL FUNCTIONS 

  • Analyze financial, operational, and clinical data to identify trends and translate insights into actionable recommendations that improve cost, quality, and utilization outcomes 
  • Partner with Regional Medical Directors to engage market MSK and PCP clinicians in understanding HOPCo’s program expectations, incentive eligibility, clinical performance data, quality metrics, and utilization trends. 
  • Create and deliver performance reviews and presentations to providers, practice leadership, and staff, clearly communicating opportunities, expectations, and progress 
  • Drive provider engagement and accountability through ongoing communication, education, and alignment to program goals, contractual requirements, and MSK best practices 
  • Lead onboarding and ongoing enablement of provider groups, ensuring alignment to program workflows, expectations, and success metrics 
  • Work with Regional Medical Directors, Network Performance, Medical Economics, and Operations teams to develop tools, resources, and reporting to support performance tracking, transparency, and continuous improvement 
  • Collaborate cross-functionally with clinical, analytics, and operations teams to address performance gaps, enhance program design, and support key initiatives 
  • Work with VP of VBC Network Management and Network Performance team to establish and execute a consistent provider engagement cadence, including quarterly business reviews and ongoing touchpoints 
  • Independently manage multiple priorities, projects, and deadlines with minimal oversight 
  • Support network growth strategies and execution  
  • Other duties as assigned  

EDUCATION 

  • Bachelor’s degree required.  
  • Master’s degree in Nursing, Healthcare Administration, Business Administration, or related field (MSN, MHA, MBA) preferred 

EXPERIENCE 

  • Minimum of 6 years of experience in value-based care, population health, or other MSK value-based care programs 
  • Demonstrated experience working with claims, quality, utilization, and performance data to drive performance improvement 
  • Proven experience engaging providers and driving performance improvement within value-based care programs 
  • Experience working in or closely with orthopedic clinical settings or MSK-focused operational environments preferred 
  • Experience supporting at-risk arrangements and/or large, coordinated provider networks, including statewide or payer-aligned networks, preferred  

REQUIREMENTS 

  • Registered Nurse (RN) or other clinically trained professional with musculoskeletal (MSK) or orthopedic experience preferred; candidates with strong MSK value-based care experience will also be considered 
  • Ability to travel up to 50%, as needed 
  • Ability to work effectively and independently in a remote environment 
  • Ability to manage multiple assigned provider practices, value-based programs, and priorities simultaneously while meeting deadlines 
  • Ability to communicate effectively, verbally and in writing, to a wide range of audiences 

KNOWLEDGE  

  • Strong understanding of MSK value-based care program design and performance drivers 
  • General clinical knowledge of orthopedics and clinical workflows. 
  • General knowledge of payor contracting.   

SKILLS 

  • Advanced Microsoft Office skills (Excel, PowerPoint, Word, PowerBI).  
  • Strong analytical and problem-solving skills; ability to translate complex data into clear findings. 
  • Strong written and oral communication skills including frequent virtual meetings. 

ABILITIES 

  • Excellent communication and presentation abilities.  

ENVIRONMENTAL WORKING CONDITIONS 

  • Standard office environment 
  • Work hours will require flexibility to accommodate meetings across different time zones. 
  • Some travel required for provider meetings, team meetings, training, or organizational events. 

PHYSICAL/MENTAL DEMANDS 

  • Requires prolonged periods of sitting and working at a computer. 
  • Manual dexterity using a keyboard and mouse 

ORGANIZATIONAL REQUIREMENTS 

  • HOPCo Mission, Vision and Values must be acknowledged and adhered to 

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.

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