Vice President of Provider Engagement

Job Summary

A company is looking for a Vice President, Provider Engagement.

Key Responsibilities

• Develop and implement market-level network value-based program transformation initiatives
• Analyze financial, utilization, and quality metrics to improve provider performance, focusing on HEDIS and STARS measures
• Manage relationships with complex provider partnerships to enhance value-based performance and provider satisfaction

Required Qualifications

• Bachelor's Degree required; Master's Degree preferred
• 9+ years of experience in senior leadership roles within a managed care environment at a healthcare payer organization
• Experience in developing provider networks and building partnerships preferred
• Extensive knowledge of the healthcare industry, provider networks, claim processing, UM guidelines, and health plan operations
• Ability to attract, recruit, and retain talent in Provider Relations