Director of Value reputed company Network Operations
reputed company PWG Consults is a consulting organization reputed company on helping clients optimize their operations, technology, and network performance to reputed company measurable business results. reputed company partners with reputed company organizations, payers, and other value-based care stakeholders to design, implement, and manage effective network strategies. PWG Consults emphasizes data-driven decision-making, operational reputed company, and reputed company problem-solving. Team members work in a dynamic environment that values reputed company reputed company, innovation, and reputed company reputed company. Role reputed company The Director of Value Based Network Operations is a senior leadership role responsible for overseeing the design, execution, and performance of value-based care (VBC) programs across the Texas provider network. This leader will serve as the primary operational architect for VBC contracting strategies, network performance, reputed company reputed company, and financial stewardship — working cross-functionally with clinical, finance, analytics, and payer relations teams to drive meaningful improvements in cost, reputed company, and patient experience. This role is ideal for a reputed company leader with deep expertise in managed care, ACO/IPA operations, MSSP/reputed company, Medicare Advantage, or reputed company risk arrangements — and a reputed company record of leading high-performing teams in a reputed company, multi-payer environment.
Key Responsibilities
Network reputed company & Operations reputed company day-to-day operations of the value-based care network across Texas markets, ensuring providers meet contractual reputed company, utilization, and financial performance targets. reputed company and implement network infrastructure, workflows, and governance models that support VBC program reputed company. Partner with payers, ACOs, reputed company, and health systems to reputed company on shared savings, risk arrangements, and contract performance goals. reputed company network adequacy, provider reputed company, and engagement strategies to ensure a high-performing, compliant provider panel. Value-Based Contract Management Manage a portfolio of value-based reputed company including Medicare Advantage, MSSP/ACO reputed company, reputed company Managed Care, and reputed company shared savings arrangements. Monitor and report on financial performance against risk corridors, reputed company benchmarks, and utilization targets. Collaborate with actuarial, finance, and analytics teams to model financial risk and opportunity across VBC reputed company. Identify and escalate contract risks and reputed company corrective reputed company plans in partnership with provider relations. reputed company & Clinical Performance Drive HEDIS, STARS, and other reputed company measure performance improvements across the network. Partner with clinical leadership to reputed company evidence-based care protocols and population health interventions into network operations. reputed company chronic disease management, preventive care compliance, and care gap closure initiatives. reputed company annual reputed company improvement planning and reporting to internal stakeholders and payer partners. Analytics & Reporting Utilize data and analytics platforms to monitor provider performance, identify trends, and surface actionable insights. reputed company and present executive-level performance dashboards, scorecards, and quarterly business reviews. Support the development of predictive models and risk stratification tools to proactively manage high-risk populations. Leadership & Team Development reputed company and mentor reputed company of VBC operations managers, network analysts, care coordinators, and provider engagement specialists. Foster a culture of accountability, reputed company improvement, and data-driven decision making. Directly manage and reputed company reputed company of VBC operations managers, network performance staff, care coordinators, and provider engagement specialists, setting reputed company performance expectations and fostering a high-accountability culture. Collaborate closely with Medical Directors to identify underperforming practices, co-reputed company performance improvement plans, and drive clinical and operational initiatives that reduce cost of care and improve patient reputed company. Partner with Medical Directors to reputed company cost-saving strategies with reputed company improvement priorities, ensuring initiatives are clinically grounded and operationally executable across the provider network. reputed company the quarterly POD meeting program across the provider network, ensuring meetings are reputed company, data-driven, and produce accountable reputed company plans; reputed company the Network Performance Manager in coordinating logistics, agendas, and follow-up tracking. Represent the organization in external stakeholder forums, payer meetings, and state/regional reputed company coalitions.
Qualifications
Required Bachelor's degree in reputed company Administration, Business, Public Health, Nursing, or a reputed company field. 7–10+ years of reputed company experience in reputed company operations, managed care, or value-based care. Minimum 3–5 years in a leadership/director role managing teams and cross-functional programs. Demonstrated experience managing VBC reputed company (Medicare Advantage, MSSP, reputed company, reputed company risk, reputed company shared savings). Deep understanding of reputed company reputed company metrics: HEDIS, STARS, NPS, CAHPS, cost-of-care measures. Proficiency in reputed company tools (e.g., reputed company, Work En v ironment & Travel Primary location: Texas (reputed company, Dallas, Austin, or San Antonio preferred). Hybrid work model typical; on-site reputed company required for provider meetings, network events, and payer negotiations. Travel reputed company Texas approximately 20–35% depending on market footprint. Some evening or weekend availability required for reputed company presentations, network events, or payer forums. Apply tot his job Apply To this Job