Manager- Market Performance & Improvement

Astrana Health, Inc. • Virginia Beach, VA

1d • $115,000 - $125,000 • Hybrid

About The Position

The Manager of Market Performance & Improvement serves as a strategic leader and subject matter expert responsible for overseeing the operational and financial performance of the Medicare product across all markets. This role is accountable for establishing and maintaining high performance in key areas including Star/Quality Ratings, risk adjustment, utilization management, and unit cost. The Manager exercises independent judgment and discretion in evaluating market-level performance, identifying systemic gaps, and leading the design and execution of multi-faceted improvement strategies that align with organizational and value-based care objectives. Working cross-functionally with providers, clinical teams, network partners, and ACO leadership, this role influences decision-making, manages large-scale projects, and ensures the effective adoption of quality, financial, and operational performance improvement strategies across multiple markets.

Requirements

• Bachelor’s degree in Business Administration, Healthcare Administration, or a related field, or equivalent combination of education and progressively responsible experience.
• 5+ years of product performance management experience, including both quantitative and qualitative performance measures.
• Demonstrated experience analyzing performance data and developing actionable, data-driven strategies.
• Demonstrated ability to exercise independent judgment and discretion in evaluating performance data and recommending business-critical solutions.
• Strong understanding of value-based care models, Medicare product performance, risk adjustment, and healthcare quality improvement methodologies.
• Advanced analytical skills with the ability to interpret complex datasets and translate findings into actionable strategies.
• Strong business and financial acumen, including understanding of quality metrics, cost drivers, utilization management, and performance incentives.
• Ability to influence provider behavior and drive change through consultative and relationship-based approaches.
• Excellent communication and presentation skills, with the ability to engage physicians, care teams, and executive leadership.
• Strong project management skills with the ability to manage multiple high-impact initiatives simultaneously.
• Proficiency in Excel, data analytics tools, and healthcare data platforms.
• Ability to work independently in a dynamic, fast-paced, multi-market environment.

Nice To Haves

• Master’s degree preferred.
• Experience in value-based care, market performance management, or quality improvement initiatives preferred.
• Experience working directly with provider groups, physicians, or clinical teams preferred.
• Project Management Professional (PMP) certification preferred.
• Clinical Licensure (RN, LVN, or equivalent) preferred.
• Certified Professional in Healthcare Quality (CPHQ), Lean/Six Sigma (Green or Black Belt), or related certification preferred.

Responsibilities

• Monitor overall provider performance utilizing performance reports including quality, utilization, referral management, and risk, as well as provider engagement activities and team feedback.
• Use data insights to prioritize provider engagements and determine the most effective intervention strategies based on performance outcomes and business impact.
• Develop provider profiles and insights to identify key areas in workflows that can be improved, including AWV processes, EMR template design, and scheduling practices.
• Understand, develop, and implement HCC (Hierarchical Condition Category) improvement activities to support accurate risk adjustment and financial performance.
• Implement provider change management activities, including organizing and structuring provider education sessions and developing tools to enhance clinical documentation and coding accuracy.
• Align in-office activities to support HCC capture and ensure optimal risk adjustment performance across the provider network.
• Understand, develop, and implement quality improvement activities such as colorectal screening programs, education webinars, EMR improvement initiatives, and medication management programs (e.g., pill delivery programs).
• Align quality improvement efforts through market vendors and internal stakeholders to ensure coordinated execution across the network.
• Lead provider education and engagement strategies designed to improve HEDIS, Stars, and other quality performance metrics.
• Analyze claims data, performance reports, and utilization reports using Excel and available technology platforms to identify trends and performance opportunities.
• Translate complex data insights into actionable performance improvement strategies tailored to individual markets and provider needs.
• Monitor progress against established goals and adjust strategies as needed to ensure performance targets are achieved.
• Use data to identify and establish relationships with key specialty groups to improve patient care and lower cost.
• Establish Joint Operating Committees (JOCs) with network partners to identify opportunities for improvement through data analysis and referral management with PCPs.
• Serve as a key liaison between provider practices and organizational leadership to escalate risks, share insights, and drive strategic alignment.
• Lead network and provider growth initiatives aligned with market expansion priorities, identifying and onboarding new provider partners to strengthen Astrana’s value-based care network.
• Collaborate with Market Operations and network development teams to assess geographic gaps, evaluate provider opportunities, and execute strategies that expand market presence and increase attributed patient populations.
• Support the integration of newly onboarded providers into performance improvement programs, ensuring alignment with quality, utilization, and financial goals from the point of engagement.
• Develop long-term and short-term goals with tracking metrics; establish role-based goals that align with Astrana organizational objectives.
• Work with team members to identify key activities that directly impact entity goals, and collaborate with ACO management to set specific performance targets for quality or financial improvement.
• Partner with internal stakeholders across Market Operations, Quality, and Population Health to ensure alignment on performance improvement initiatives.
• Manage multiple large, cross-functional projects simultaneously, ensuring timely delivery and measurable impact.

Benefits

• The total compensation target pay range for this role is: $115,000 to $125,000.
• Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
• Equal Employment Opportunity and Affirmative Action employer.
• We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.
• All employment is decided on the basis of qualifications, merit, and business need.
• If you require assistance in applying for open positions due to a disability, please email us at [email protected] to request an accommodation.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager