Director, Value‑Based Network Performance & Risk

CareSource; Northern (KY); Hybrid; USD 113,000 - 198,000; Full time

Job summary

CareSource in Kentucky seeks a Director, Network Performance & Engagement to lead provider network operations, focusing on value-based contracting, TCOC initiatives, and quality programs. You will guide strategy, analytics, and implementations to improve member outcomes and cost efficiency.

Responsibilities include overseeing contracting, network access, regional business planning, stakeholder engagement, budgeting, and performance improvement initiatives, with travel up to 25%.

Qualifications

• 5+ years in healthcare network management
• 5+ years of leadership/management experience
• Managed Care experience preferred

Responsibilities

• Oversee provider contracting and network relationships to ensure satisfaction
• Lead initiatives to improve quality outcomes and risk adjustment scoring
• Develop regional business plans to expand service area and enrollment
• Monitor budgeting and forecasting to meet financial goals
• Represent CareSource in local markets and industry organizations
• Coordinate policy development and performance improvement efforts

Skills

Value Based Contracting

Regulatory requirements

Financial acumen

Strategic thinking

Leadership

Education

Bachelor's degree in management/healthcare management

Master's degree preferred

Tools

Microsoft Office

Job description

CareSource in Kentucky seeks a Director, Network Performance & Engagement to lead provider network operations, focusing on value-based contracting, TCOC initiatives, and quality programs. You will guide strategy, analytics, and implementations to improve member outcomes and cost efficiency.

Responsibilities include overseeing contracting, network access, regional business planning, stakeholder engagement, budgeting, and performance improvement initiatives, with travel up to 25%.