Director of Provider Engagement & Partnerships - Hybrid

MetroPlusHealth; New York (NY); Hybrid; USD 150,000 - 180,000; Full time

Job summary

MetroPlusHealth in New York City is seeking a Director of Provider Engagement to lead the Provider Engagement team and drive performance across quality, risk adjustment, utilization management, and membership growth.

You will coordinate QBRs with major provider partners, oversee Provider Relations for large hospital networks, and collaborate with Quality, Risk, Clinical Services, and Sales to deliver a best-in-class provider experience.

Qualifications

• Master of Public Administration (MPA) or Master of Public Health (MPH) degree required.
• 5-7 years of healthcare industry experience in provider network management or value-based environment.
• Equivalent combination of education, training, and minimum 10 years of relevant experience acceptable.
• Strong healthcare and financial data analysis skills.
• Knowledge of IPAs, large provider groups, hospital systems, and diverse communities.

Responsibilities

• Lead Provider Engagement team to drive quality, risk adjustment, utilization management, financial performance, and membership growth.
• Coordinate Quarterly Business Reviews (QBRs) and operational meetings to drive performance.
• Develop and oversee Provider Engagement functions including establishing key provider partnerships and setting up QBR meetings.
• Establish strategy and action plan with formalized QBR agenda, content, analytics and aligned goals.
• Oversee Provider Relations team assigned to large network hospitals; foster partnerships.
• Review data and analytics of provider group performance to identify improvement opportunities.
• Collaborate with Quality Management, Risk Adjustment, Clinical Services, Sales to monitor trends and plan improvements.
• Ensure compliance with Federal and State rules, regulations, and policies.

Skills

Leadership

Strategic thinking

Data analysis

Communication

Education

MPA or MPH degree

Equivalent combination with 10 years experience

Job description

MetroPlusHealth in New York City is seeking a Director of Provider Engagement to lead the Provider Engagement team and drive performance across quality, risk adjustment, utilization management, and membership growth.

You will coordinate QBRs with major provider partners, oversee Provider Relations for large hospital networks, and collaborate with Quality, Risk, Clinical Services, and Sales to deliver a best-in-class provider experience.