Strategic Provider Performance Engagement Lead

CareSource; United States; Remote; USD 83,000 - 133,000; Full time

Job summary

CareSource is seeking a Manager, Provider Performance Engagement to oversee performance engagement activities with internal and external partners, focusing on improving health outcomes and total cost of care. You will align provider interventions with engagement plans, oversee implementation, assess results, and guide improvements.

The role requires collaboration with health partners, leadership experience, and strong regulatory knowledge to ensure compliant processes and successful program

Qualifications

• Bachelor’s degree or equivalent years of relevant work experience is required
• Master’s degree in business or health related field is preferred
• Minimum of five (5) years of experience working collaboratively with external Health Partners is required
• Familiarity of the healthcare field and experience with payer-provider integration is required
• Minimum of one (1) year leadership/management experience preferred

Responsibilities

• Conduct internal and external meetings to establish and execute on detailed provider performance engagement plans for new and existing providers
• Manage customized provider plans to support key quality metrics to ensure positive outcomes
• Manage process development activities for provider onboarding and oversight
• Ensure compliance with state, federal and regulatory body requirements
• Assist with the development and maintenance of departmental policies and procedures for oversight of contracted providers in an Alternative Payment Model (APM)
• Analyze, update, and modify procedures to continually improve engagement processes
• Review and incorporate data analysis for program metrics, outcome measures and results, and savings opportunities
• Support and manage financial ROI, quality metrics, and service level agreements to evaluate success of provider engagement initiatives
• Identify and manage risk associated with any process change, implement mitigation strategies & communicate/escalate to stakeholders
• Report provider APM program progress and oversight status to all stakeholders
• Ensure provider performance engagement milestone deliverables are completed for each project phase
• Maintain internal strategic alignment when prioritizing projects by following established RACI document to ensure appropriate engagement for stakeholders,
• Participate in Provider Oversight Committee meetings with internal business owners and providers
• Provide leadership guidance to ensure staff career growth
• Oversee day-to-day activities of staff to ensure department goals are achieved
• Strategically manage department staff objectives and prioritization to ensure alignment with market and corporate goals
• Perform any other job-related instructions as requested

Skills

Project management

Regulatory knowledge

PCMH concepts

Communication skills

Leadership

Analytical skills

Stakeholder engagement

Time management

Education

Bachelor’s degree or equivalent years of relevant work experience

Master’s degree in business or health related field

Tools

Microsoft Office

Microsoft Project

Excel

Job description

CareSource is seeking a Manager, Provider Performance Engagement to oversee performance engagement activities with internal and external partners, focusing on improving health outcomes and total cost of care. You will align provider interventions with engagement plans, oversee implementation, assess results, and guide improvements.

The role requires collaboration with health partners, leadership experience, and strong regulatory knowledge to ensure compliant processes and successful program