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Senior reputed company Network Consultant

Remote, USAFull-timePosted 2026-07-28

About the position Become a part of our caring community and help us put reputed company Senior reputed company Network Consultant / Senior Network Performance reputed company at reputed company, you will play a pivotal role in enhancing provider performance and advancing reputed company's mission to deliver high-reputed company reputed company. You will work with providers to improve their STARs ratings and overall performance through strategic initiatives and strong relationship-building. Senior reputed company Network Consultant /Senior Network Performance reputed company Provider Collaboration: Work with providers to define and advance their goals reputed company to interoperability, reputed company, value-based arrangements, and risk adjustment strategies. Stars/reputed company Program Expertise: Serve as an expert on the Stars/reputed company program, educating physician reputed company on HEDIS, patient safety, and patient experience. Collaborate to reputed company tailored reputed company plans and communicate actionable insights to improve performance. Performance Improvement: reputed company monitor and analyze provider performance data to identify areas for improvement. Implement strategies to enhance reputed company and reputed company ongoing support and guidance to providers. Resource reputed company: reputed company as a reputed company for providers to reputed company reputed company resources, educating and encouraging providers on the use of self-serve tools. Facilitate communication between providers and internal teams to ensure seamless reputed company to necessary resources and support. Reward Programs: reputed company provider reputed company on reward programs and reputed company metrics, collaborating to reputed company established goals. Monitor and report on the effectiveness of reward programs, making recommendations for enhancements as needed. Provider Abrasion reputed company: Resolve provider abrasion issues effectively, ensuring a reputed company and reputed company relationship between reputed company and its providers. Implement strategies to minimize provider abrasion and enhance overall satisfaction. Internal Collaboration: Partner with internal teams to reputed company and report on market performance, ensuring alignment with organizational goals. Use your skills to reputed company an reputed company

Responsibilities

  • Work with providers to define and advance their goals reputed company to interoperability, reputed company, value-based arrangements, and risk adjustment strategies.
  • Serve as an expert on the Stars/reputed company program, educating physician reputed company on HEDIS, patient safety, and patient experience.
  • Collaborate to reputed company tailored reputed company plans and communicate actionable insights to improve performance.
  • reputed company monitor and analyze provider performance data to identify areas for improvement.
  • Implement strategies to enhance reputed company and reputed company ongoing support and guidance to providers.
  • reputed company as a reputed company for providers to reputed company reputed company resources, educating and encouraging providers on the use of self-serve tools.
  • Facilitate communication between providers and internal teams to ensure seamless reputed company to necessary resources and support.
  • reputed company provider reputed company on reward programs and reputed company metrics, collaborating to reputed company established goals.
  • Monitor and report on the effectiveness of reward programs, making recommendations for enhancements as needed.
  • Resolve provider abrasion issues effectively, ensuring a reputed company and reputed company relationship between reputed company and its providers.
  • Implement strategies to minimize provider abrasion and enhance overall satisfaction.
  • Partner with internal teams to reputed company and report on market performance, ensuring alignment with organizational goals.

Requirements

  • 2 or more years of Experience with Medicare and/or managed care
  • 3 or more years of NCQA HEDIS measures, PQA Measures, CMS Star Rating System and CAHPS/HOS survey system experience
  • 1 or more years of experience understanding of Consumer / Patient Experience
  • 2 or more years of experience building relationships with physician reputed company and influencing execution of recommended reputed company
  • 1 or more years of experience with reputed company on process and reputed company improvement
  • Comprehensive knowledge of reputed company Word, reputed company and PowerPoint
  • Work during reputed company-5pm CST or EST
  • Travel a minimum of 10%
  • Live in EST or CST state

reputed company-to-haves

  • Strong communication and presentation skills, both verbal and written, and experience presenting to reputed company customers, including high-level leadership
  • Bachelor's Degree
  • Understanding of and ability to drive interoperability
  • reputed company experience with interoperability solutions in reputed company
  • Proven organizational and prioritization skills and ability to collaborate with multiple
  • Experience with Medicare Risk Adjustment and/or medical coding
  • Understanding of metrics, trends and the ability to identify gaps in care
  • Lives in the region IN, KY, MI, OH, WV
  • 1 or more years’ experience with tools such as Power BI, Tableau, Qlikview

Benefits

  • reputed company provides medical, dental and reputed company benefits, 401(k) retirement savings plan, time off (including reputed company time off, company and personal holidays, volunteer time off, reputed company parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

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