Tandym Group is Hiring a Director of Provider Engagement - Managed Care - Manhattan NY - Hybrid Near New York, NY
A health services organization in New York City is currently seeking an experienced professional to join their staff as their new Director of Provider Engagement. In this role, the Director of Provider Engagement will be responsible for to developing and maximizing improved alignment, driving high performance and providing world-class engagement experience with the highest profile providers for the organization.
Responsibilities:
The Director of Provider Engagement will be responsible for:
Lead the Provider Engagement team under the Vice President of Provider Network Operations
Develop and execute strategies to enhance alignment and performance with key providers
Drive market-level projects to optimize quality, risk adjustment, utilization management, financial performance, and membership growth
Build strategic partnerships aligned with business goals through Provider Engagement functions management
Create and formalize Provider Engagement strategy, including Quarterly Business Review (QBR) processes
Analyze provider group performance data to identify improvement opportunities and focus areas
Collaborate cross-functionally with Quality Management, Risk Adjustment, Clinical Services, and Sales to monitor and enhance performance trends
Align partnership goals with providers' business strategies, ensuring mutual understanding and shared objectives
Conduct Quarterly Business Reviews (QBR) covering financial, quality, utilization, and membership metrics
Generate executive-level monthly reports on Provider Engagement activities, performance, and goal progress
Associate's Degree required; Bachelor's degree or equivalent combination of education, training, and a minimum of 10 years of relevant healthcare industry experience in provider network management and value-based environments
5-7 years of relevant healthcare industry experience in provider network management and value-based environments
Strong background in managed care, preferably with experience in network management and value-based roles
Excellent healthcare and financial data analysis skills required
Knowledge of IPAs, large provider groups, hospital systems, and diverse communities necessary for targeting providers serving various demographics
Ability to interpret contractual language and effectively communicate messages to clients and customers through written and verbal communication
Experience in facilitating and/or negotiating contractual arrangements
Desired Skills:
Master of Public Administration (MPA) or Master of Public Health (MPH) degree