Director, Provider Performance & Growth

SHPCA SCAN Health Plan; City of Long Beach (NY); On-site; USD 148,000 - 214,000; Full time

Benefits offered by this job

Base salary range

Onsite work

Annual bonus

Wellness program

Paid time off

Holidays

401(k) plan

Recognition program

Tuition reimbursement

Job summary

SCAN Health Plan, a nonprofit focused on advancing care for older adults, seeks a Director of Market Performance to build and lead enterprise provider performance programs across markets. You will define KPIs, translate analytics into action, and develop playbooks, dashboards, and governance to drive quality, cost, and member experience improvements.

The role requires deep Health Plan operations knowledge, strong leadership, and the ability to manage complex, cross-market initiatives with

Qualifications

• Bachelor's Degree or equivalent experience in Business Administration, Health Care Administration, Public Health, Finance, Operations, Analytics, or a related field.
• Graduate or Advanced Degree or equivalent experience.
• 7+ years of progressively responsible experience in provider performance, health plan operations, provider relations, value-based care, population health, risk adjustment, quality improvement, analytics, or operational transformation required.
• Prior leadership experience developing enterprise programs, performance frameworks, provider engagement strategies, or cross-functional initiatives required.
• Strong knowledge of health plan operations, provider performance management, value-based care, quality improvement, Stars performance, risk adjustment, and provider engagement strategies.
• Ability to translate complex data, analytics, and performance insights into actionable strategies, executive-ready reporting, and operational improvement plans.
• Excellent verbal and written communication skills, including the ability to develop provider-facing materials, executive presentations, dashboards, playbooks, and training content.
• Ability to define cross-functional KPIs, design scalable processes, governance structures, service models, and performance improvement frameworks across multiple markets.
• Strong program management, analytical, problem-solving, decision-making, and organizational skills.
• Advanced relationship management, stakeholder engagement, and partnership-building capabilities.
• Ability to manage competing priorities and lead complex initiatives in a fast-paced, matrixed environment.
• Ability to promote innovation, continuous improvement, and adoption of new technologies, including artificial intelligence-enabled solutions.
• Advanced technical skills are required with Microsoft Office Suite, Visio, and SQL.

Responsibilities

• Lead the development, maintenance, and continuous improvement of enterprise-wide provider performance playbooks, frameworks, and execution standards across all markets.
• Partner with subject matter experts and business leaders to define, operationalize, and monitor key performance indicators across quality, cost, growth, member experience, access, risk adjustment, coding accuracy, and provider performance.
• Translate data, analytics, and performance insights into actionable provider interventions that improve quality outcomes, Stars performance, affordability, coding accuracy, access, and member experience.
• Create standardized performance improvement tools, executive-ready reporting, provider-facing materials, scorecards, dashboards, training content, and engagement resources.
• Establish governance processes to monitor performance trends, identify risks, evaluate intervention effectiveness, and recommend corrective actions across provider partners and markets.
• Serve as the business lead for operational initiatives that impact provider performance, including encounter submission onboarding, gap closure processes, provider training, vendor management, and audit reporting frameworks.
• Drive implementation of innovative provider performance and operational transformation programs, including advanced coding accuracy initiatives, and technology-enabled process improvements.
• Lead change management and training efforts to support adoption of provider engagement standards, performance improvement programs, reporting practices, and market performance strategies.
• Design and implement the long-term provider service model strategy, including provider-facing support functions, shared service models, centralized intake, case routing, escalation processes, CRM strategy, provider portals, and service model enhancements.

Skills

Provider performance

Leadership experience

Data analytics

Communication skills

Stakeholder management

Cross-functional work

Project management

Education

Bachelor's degree

Graduate degree

Tools

SQL

Microsoft Office

Visio

Job description

SCAN Health Plan, a nonprofit focused on advancing care for older adults, seeks a Director of Market Performance to build and lead enterprise provider performance programs across markets. You will define KPIs, translate analytics into action, and develop playbooks, dashboards, and governance to drive quality, cost, and member experience improvements.

The role requires deep Health Plan operations knowledge, strong leadership, and the ability to manage complex, cross-market initiatives with