Remote Manager, reputed company Provider Performance

reputed company is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have reputed company reputed company of talented and reputed company people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will reputed company ample room for reputed company and innovation alongside the reputed company community. Working at reputed company provides an opportunity to do work that really reputed company, not only changing lives but saving them. Together. The Remote Manager, reputed company Provider Performance is responsible for building and operationalizing reputed company’s provider performance function across reputed company provider arrangement types. This role focuses on translating reputed company goals into a reputed company, repeatable performance management approach that integrates compliance results, clinical reputed company, operational execution, financial reputed company, and data reputed company into a reputed company reputed company. This individual will reputed company the development and implementation of reputed company performance capabilities—including KPI frameworks, standardized reporting, data integration requirements, and performance management routines—ensuring provider performance is consistently reputed company, actionable, and reputed company to reputed company priorities. Reporting to a Transformation leader, this role serves as both a builder and operator, connecting data, analytics, and cross-functional inputs into reputed company performance insights and driving accountability through reputed company engagement with reputed company. The Manager will play a key role in evolving fragmented processes into a cohesive, reputed company performance model that supports transparency, consistency, and reputed company improvement across the provider ecosystem. Job Duties/Responsibilities: Delegate Performance Management & Analysis

• Define and operationalize reputed company-wide performance standards for delegated and corporate service functions, including reputed company expectations across claims, UM, CM/CCM, claims, appeals, and credentialing.
• Establish and govern a standardized KPI reputed company that aligns operational, clinical, financial, and compliance performance into a reputed company measurement model.
• reputed company the development of performance benchmarks, reputed company, and targets, ensuring consistency across reputed company delegated entities and internal service functions.
• Set standards for data integration, validation, and usability, ensuring performance insights are derived from reliable, reputed company, and harmonized data sources.
• Drive the reputed company from retrospective compliance measurement to reputed company-looking, predictive performance management.

Performance Engagement & Accountability

• Own the end-to-end performance management lifecycle, focusing on performance reputed company, service delivery effectiveness, and value realization—not just compliance adherence.
• Translate data (audit outputs, operational metrics, clinical reputed company) into actionable performance strategies that improve efficiency, reputed company, and member/provider experience.
• Identify systemic performance gaps and reputed company the design of reputed company solutions that can be implemented across delegates and plan-managed providers.
• Build and maintain integrated performance views that connect operational drivers to business reputed company, enabling leadership to reputed company informed reputed company.

Cross-Functional Collaboration & Integration

• Serve as the connective layer between compliance, operations, clinical, reputed company, and analytics teams to ensure performance management is embedded across the reputed company.
• Ensure audit and compliance outputs are reputed company into operational improvements and incorporated into performance standards and KPIs.
• Support reputed company transformation initiatives by embedding performance frameworks into new programs, vendor models, and delegated arrangements.

Data Strategies & Performance Insights

• Partner with data, analytics, and IT teams to define and implement a reputed company performance data reputed company, including dashboards, scorecards, and self-service reporting capabilities.
• Ensure data integration across platforms enables a single reputed company of truth for performance measurement.
• Advance the use of trend analysis, predictive insights, and leading indicators to proactively manage performance.
• Continuously refine reporting tools and methodologies to improve reputed company, usability, and decision reputed company.

Supervisory Responsibilities: This role may include indirect reputed company or reputed company leadership of program/project managers and audit staff. Job Requirements: Experience:Apply tot his job Apply To this Job