Director of Network Performance & Risk Strategy

CareSource; United States; On-site; USD 113,000 - 198,000; Full time

Job summary

CareSource is seeking a Director, Network Performance & Engagement to provide expert leadership in provider network operations, including Total Cost of Care (TCOC), value-based purchasing, and state or federal quality initiatives, with a focus on identifying strategic and financial opportunities/risks.

The role includes overseeing contracting and relationships with providers, driving quality improvements, managing budgets, and collaborating across teams to implement practical solutions that

Qualifications

• Five years in healthcare network management.
• Five years of leadership/management experience.
• Managed Care experience preferred.

Responsibilities

• Oversee and monitor provider contracting and relationships.
• Assist in analysis and implementation of initiatives to improve quality outcomes and risk adjustment.
• Monitor network access standards and recruitment for market gaps/new product development.
• Develop regional business plans to expand service area and enrollment, improve outcomes.
• Represent CareSource to local markets and participate in industry groups.
• Monitor budgeting and forecasting to meet financial goals.
• Collaborate with staff, consultants and IT to design improvement plans.
• Develop and apply policies, standards, metrics and quality controls.
• Coordinate performance improvement measurement, reporting and feedback systems.
• Serve as system administrator for contract management databases and upgrades.

Skills

Value Based Contracting

Microsoft Office

Provider contracting

Regulatory knowledge

Communication skills

Financial acumen

Healthcare network management

Team leadership

Change management

Member experience

Education

Bachelor's degree in management

Master's degree in business

Equivalent years of relevant work experience

Job description

CareSource is seeking a Director, Network Performance & Engagement to provide expert leadership in provider network operations, including Total Cost of Care (TCOC), value-based purchasing, and state or federal quality initiatives, with a focus on identifying strategic and financial opportunities/risks.

The role includes overseeing contracting and relationships with providers, driving quality improvements, managing budgets, and collaborating across teams to implement practical solutions that