Manager Provider Performance

Role Overview:  The Manager of Provider Performance oversees the development, maintenance, and settlement of provider incentive models. This role leads a team responsible for analyzing utilization and cost data, developing metrics to evaluate provider performance, and delivering business and statistical insights with actionable recommendations. The manager synthesizes data from multiple sources to design performance stratification metrics and identifies opportunities for medical cost reduction, program enhancements, and alternative pricing strategies.

Work Arrangement:

• Remote - This position is fully remote and may be performed from any location within the United States; however, the associate must work during Eastern Standard Time (EST).

Responsibilities:  

• Works closely with business partners to develop and monitor appropriate valuation methodologies for medical and/or network management programs and initiatives.
• Supports the development and implementation of strategic business programs and products through effective extraction, analysis, and summarization of appropriate data sets and benchmarks.
• Leads a team of Analysts to provide strong analytics in support of business and strategic goals and initiatives.
• Ensures a high level of quality in the analytics and data sets produced by the team.
• Participates in cross-functional corporate business teams in the development of medical economics programs, metrics, targets, and results as they relate to specific corporate initiatives and programs.
• Conducts outcomes research and findings to measure the extent to which business solutions improve patient well-being, financial performance, and the achievement of corporate goals
• Produces comprehensive and valid reports and results to allow for more effective management and growth of the business
• Proactively supports efforts to optimize the accuracy, timeliness, and completeness of data resources.
• Utilizes explanatory/predictive models in the development, support, and analysis of business initiatives.
• Maintains an awareness of the evolving healthcare industry and translates knowledge into business opportunities. 

Education & Experience:

• Bachelor’s Degree in a relevant field required.
• 5 years of experience in the healthcare or managed care industry with a focus on value-based programs
• 7 years of data analysis and reporting, and proven experience leading a team of analysts.
• Extensive knowledge of Microsoft Office products is required.
• Proficiency in coding solutions in Microsoft SQL Server using SQL Server Management Studio required.
• Experience in the design and administration of Value-based programs and statutory reporting is a plus.

Skills & Abilities:

• Strong analytical skills with the ability to work with healthcare cost, utilization, quality, and provider data
• Experience in analyzing data and turning findings into clear reports and recommendations
• Create and track performance metrics and benchmarks
• Partner with business and clinical stakeholders across departments
• Communicate complex data insights clearly to non‑technical audiences
• Ability to manage multiple projects and priorities simultaneously
• Understanding of healthcare, managed care, and value‑based programs

• Demonstrated ability to manage the delivery high quality outputs under tight deadlines.