Provider Performance & SLA Manager

HMSA; Honolulu (HI); On-site; USD 120,000 - 180,000; Full time

Job summary

HMSA in Hawaii seeks an experienced Provider Performance Manager to lead how we monitor and improve provider contract performance. You will oversee governance, analytics, and reporting, ensuring compliance with SLAs and regulatory requirements, while guiding negotiations and fee reviews.

This role collaborates across teams to optimize access and outcomes for members and drive continuous improvement. Jointly with cross-functional teams, you will implement data-driven strategies to improve

Responsibilities

• Lead provider performance management activities across contract requirements and SLAs.
• Oversee performance governance for provider services contracts, including reporting and penalties.
• Develop and measure provider network performance metrics (cost, quality, accessibility).
• Ensure regulatory network requirements are measured and reported (ACA, QUEST, Medicare, HMSA).
• Oversee data analysis for contract negotiations and fee reviews.
• Oversee out-of-network access strategies (single case agreements and network solutions).
• Perform all other duties as assigned.

Job description

HMSA in Hawaii seeks an experienced Provider Performance Manager to lead how we monitor and improve provider contract performance. You will oversee governance, analytics, and reporting, ensuring compliance with SLAs and regulatory requirements, while guiding negotiations and fee reviews.

This role collaborates across teams to optimize access and outcomes for members and drive continuous improvement. Jointly with cross-functional teams, you will implement data-driven strategies to improve