Provider Performance Advisor

Job Summary

Supporting the Provider Network Management team, the fully remote Provider Performance Advisor will produce performance reports, analyze claims data, and collaborate with providers to enhance care coordination and practice efficiencies.

Key responsibilities

• Produce quality and performance-related reporting to identify opportunities and strategies for improvement
• Interpret claims data to connect patient outcomes with utilization trends and optimize performance based on quality improvement programs
• Conduct meetings with providers to review performance data, address care gaps, and develop action plans in collaboration with relevant teams

Required qualifications

• Bachelor's degree in healthcare administration or a related field, or 5+ years of relevant experience without a degree
• 3+ years of experience in Account Executive roles, with knowledge of total cost of care and reimbursement methodologies
• Familiarity with quality and provider performance reporting, including HEDIS and other quality measures
• Understanding of healthcare regulations, reimbursement models, and quality measures
• Strong analytical skills to interpret and prepare provider performance data