Director of Payor Performance and Network Operations

Summit Medical Group; United States; Remote; USD 120,000 - 152,000; Full time

Job summary

An established industry player is seeking a Director of Payor Performance and Network Operations to lead transformative efforts in primary care delivery. This role is pivotal in enhancing payor relationships and optimizing healthcare costs through innovative strategies and data-driven insights. As part of a compassionate community, you will work collaboratively with physicians and staff to ensure high-quality, patient-centered care. If you are passionate about driving excellence in healthcare and thrive in a dynamic environment, this opportunity offers a chance to make a significant impact on patient outcomes and operational efficiencies.

Benefits

Health Insurance

Dental Insurance

Life Insurance

Disability Insurance

Vision Insurance

401k Plan

Flexible Spending Account (FSA)

Qualifications

• 7+ years of healthcare management experience required.
• Experience with population management and value-based care essential.

Responsibilities

• Develop and oversee specialty network workflows and outcomes.
• Use analytics to enhance payor program outcomes and improve patient care.

Skills

Leadership

Data Analysis

Communication Skills

Problem-Solving

Critical Thinking

Healthcare Management

Population Health Knowledge

Change Management

Education

Bachelor’s in Healthcare or Related Field

Master’s Degree

Tools

Microsoft Excel

Microsoft PowerPoint

EMR Systems

Job description

Director of Payor Performance and Network Operations

We’re a physician-led, patient-centric network committed to simplifying health care and bringing a more connected kind of care.

When you join our team, you become part of a compassionate community of people who work hard every day to make health care better for all. We are innovating value-based care and leveraging integrated applications, population insights, and staffing expertise to ensure all patients have access to high-quality, connected care services that provide better outcomes at a reduced total cost of care.

Please Note: We will only contact candidates regarding your applications from one of the following domains: @summithealth.com, @citymd.net, @villagemd.com, @villagemedical.com, @westmedgroup.com, @starlingphysicians.com, or @bmctotalcare.com.

Job Description

At VillageMD, we're looking for a Director of Payor Performance and Network Operations to help us transform primary care delivery and patient service. As a national healthcare leader, we've partnered with top primary care physicians, providing them with digital tools, strategic support, and innovative practices.

Our goal is to create accessible, effective, and efficient care that is value-based, physician-driven, and patient-centered. We seek individuals who share our pursuit of excellence, are adaptable, and committed to continuous learning.

In this role, you will work across all markets to improve payor contract performance under value-based arrangements. You will collaborate with teams and practice staff to integrate analytics, ancillary, and operational capabilities, managing patient populations to improve healthcare outcomes, reduce costs, and enhance patient and clinician experiences.

Could this be you?

The Director will oversee the development, implementation, and management of the organization's specialty network workflows and outcomes. Key responsibilities include designing and refining market processes, nurturing payor relationships, resolving issues, and optimizing operational and financial performance. A deep understanding of payor and primary care-specialist relationships, healthcare analytics, and stakeholder collaboration is essential.

How you can make a difference

• Strategic Planning & Program Development: Develop and execute the specialty network and referral strategies, set performance metrics, and monitor outcomes.
• Data Analysis & Performance Improvement: Use analytics to monitor performance, identify improvement areas, and develop strategies based on cost, quality, and utilization data.
• Physician and Clinical Staff Engagement: Engage and align clinical staff with initiatives, providing education and resources for successful implementation.
• Collaboration: Partner with market leadership to optimize contract performance.
• Quality & Patient Experience: Lead initiatives to improve care quality and patient satisfaction within the network.
• Regulatory Compliance: Ensure adherence to relevant regulations and reporting standards.
• Team Leadership & Development: Guide managers, set clear goals, and foster trust to influence decisions and gain buy-in.
• Market Analysis & Research: Stay informed on industry trends and identify new opportunities.
• Effective Communication: Lead performance reviews using operational reports.

Core competencies

• Influence and leadership skills
• Excellent communication and interpersonal skills
• Data analysis and insight development
• Partnership cultivation
• Problem-solving and decision-making abilities

Skills for success

• Proven leadership with results orientation
• Critical thinking coupled with hands-on execution
• Accountability and results-driven mindset
• Change management partnering with physicians
• Knowledge of population health and value-based care data

Experience to drive change

• Bachelor’s in healthcare or related field; master’s preferred
• At least 7 years in healthcare management
• Experience with Population Management and Value-Based Care, preferably in leadership roles
• Ability to translate data into practice and influence physician behavior
• Experience managing P&L or large projects
• Proficiency in Microsoft Excel and PowerPoint; experience with EMR and healthcare data reporting preferred

This is an exempt position. The salary range is $120,800 to $151,100, based on experience and other factors. Benefits include health, dental, life insurance, and a 401k plan.

About Our Commitment

Total Rewards at VillageMD

Our team is vital to reshaping healthcare through connection. We value health and wellness for our employees and their families, offering comprehensive benefits including Medical, Dental, Life, Disability, Vision, FSA, and a 401k plan.

Equal Opportunity Employer

We provide equal employment opportunities regardless of race, color, religion, gender, sexual orientation, gender identity, national origin, age, disability, or other protected characteristics.

Safety Disclaimer

We prioritize safety and do not use informal chat platforms for job communications. Be cautious of scams; official interviews are conducted at our locations during business hours. For scam info, visit FTC Job Scams.

About the company

Summit Medical Group is among the largest physician-owned multispecialty practices in the U.S., with a main campus and 67 satellite offices in New Jersey, employing over 600 staff.