- Job Title: Director of Provider Engagement
- Company: MetroPlusHealth
- Develop and oversee all Provider Engagement functions, including establishing key partnerships and organizing QBR meetings.
- Formulate Provider Engagement strategy, formalize QBR agenda, content, analytics, and goals.
- Analyze data and provider group performance to identify areas for enhancement and develop improvement strategies.
- Collaborate efficiently with internal teams like Quality Management, Risk Adjustment, Clinical Services, and Sales to track trends and devise plans for improvement.
- Understand providers' business objectives and strategies to align on partnership goals.
- Conduct effective Quarterly Business Reviews with a structured agenda covering financial, quality, utilization, and membership reporting.
- Generate Executive-level monthly reports on all Provider Engagement activities, performance, and goal progress.
- Create monthly executive reports on key provider performance, progress on initiatives, and activity.
- Promote a culture of accountability focusing on people and performance management, coaching, development, and employee engagement.
- Master of Public Administration (MPA) or Master of Public Health (MPH) degree required
- 5-7 years of relevant healthcare industry experience in provider network management and a value-based environment; or a minimum of 10 years of relevant experience in the healthcare industry
- Strong background in healthcare, specifically in a network management and value-based role
- Excellent healthcare and financial data analysis skills
- Knowledge of IPAs, large provider groups, hospital systems, and diverse communities
- Ability to interpret contractual language and communicate effectively with clients and customers
- Experience in facilitating and contracting arrangements
- Integrity and Trust
- Customer Focus
- Functional/Technical skills
- Excellent verbal and written communication abilities to interact credibly and effectively across all levels of an organization
- Proven ability to initiate tasks independently, think strategically, handle complexity, and adapt to changing environments
- Capability to establish enduring positive relationships
- Aptitude for driving effective change
- Strong business acumen, analytical skills, critical thinking, and persuasion abilities
- Demonstrated proficiency in building cross-functional relationships and leading effective teams
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Director of Provider Engagement - Long Island City, United States - MetroPlusHealth
Description
Empower. Unite. Care.
About MetroPlusHealth:
MetroPlusHealth is dedicated to empowering New Yorkers by uniting communities through care. They strongly believe that healthcare is a fundamental right, not a privilege.
If you possess compassion and a collaborative mindset, MetroPlusHealth invites you to join their team. Working with them, you can feel proud of your contributions every day.
About NYC Health + Hospitals:
MetroPlusHealth offers top-quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens, and Staten Island. Their wide range of products includes New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, and more.
As a subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth's network comprises over 27,000 primary care providers, specialists, and participating clinics.
For over 30 years, MetroPlusHealth has forged strong relationships with members and providers to support New Yorkers in living their healthiest lives.
Position Overview:
Reporting to the Vice President of Provider Network Operations, the Director of Provider Engagement will head the Provider Engagement team. This role carries the overall responsibility for developing and optimizing alignment, fostering high performance, and delivering a top-notch engagement experience with key providers.
Through leading market-level projects and strategies for provider engagement, the Director will enhance performance in quality, risk adjustment, utilization management, financial outcomes, and membership growth.
The team will act as the primary point of contact for key provider groups, coordinating Quarterly Business Reviews (QBRs) and operational meetings to drive performance.
Success in this position will be gauged by achieving goals aligned with membership growth, quality improvement, risk adjustment, utilization management, and overall financial performance.
Job Description:
Minimum Qualifications:
Professional Competencies:
