Manager, Provider Performance Engagement-Must Reside in OHIO!

CareSource•Ohio WFH, OH

1d•$83,000 - $132,800•Onsite

About The Position

The Manager, Provider Performance Engagement oversees performance engagement activities with internal and external partners, focusing on improving health outcomes and total cost of care. The role aligns provider interventions with customized Alternative Payment Model (APM) engagement plans, oversees implementation, assesses results, and guides improvement opportunities. The manager also leads staff and department priorities to support market and corporate goals. The position requires residence in Ohio. The role is based in a general office environment, where the employee may need to sit or stand for extended periods. Influenza vaccination is required for designated positions during influenza season (October 1–March 31), with employees hired during that period given 30 days from hire to complete the vaccination and provide verified documentation. CareSource provides reasonable accommodations through an interactive review process.

Requirements

Bachelor's degree or equivalent years of relevant work experience.
At least five years of experience working collaboratively with external health partners.
Familiarity with the healthcare field and experience with payer-provider integration.
Proficiency with Microsoft Office tools, including Project, Word, and Excel.
Thorough understanding of project management processes, techniques, and tools.
In-depth knowledge of regulatory and quality standards and measures, including State Medicaid programs, Medicare, and quality accreditation (e.g., ODM, CMS, NCQA, and URAC).
In-depth knowledge of Patient Centered Medical Home (PCMH) concepts and processes.
Ability to communicate before individuals, groups, and executive leadership.
Ability to interact effectively with all levels of management.
Flexibility during organizational or business changes.
Strong analysis and collaboration skills; sense of urgency; and exceptional emotional intelligence.
Excellent written and verbal communication, interpersonal, and relationship-building skills.
Ability to work independently and in a team environment, multitask, and prioritize work to meet project deadlines.
Effective listening, critical-thinking, time-management, customer-service, decision-making, and problem-solving skills.
Excellent planning, negotiating, and influencing skills.
Must reside in Ohio.
Annual influenza vaccination and proof of vaccination are required for designated positions during influenza season (October 1–March 31), subject to the stated 30-day completion period for employees hired during that season.

Nice To Haves

Master’s degree in business or a health-related field.
At least one year of leadership or management experience.

Responsibilities

Conduct internal and external meetings to establish and execute detailed provider performance engagement plans for new and existing providers.
Manage customized provider plans that support key quality metrics and positive outcomes.
Manage process development for provider onboarding and oversight.
Ensure compliance with state, federal, and regulatory requirements.
Assist with developing and maintaining departmental policies and procedures for oversight of contracted providers in an Alternative Payment Model (APM).
Analyze, update, and modify procedures to continually improve engagement processes.
Review and incorporate data analysis for program metrics, outcome measures and results, and savings opportunities.
Support and manage financial ROI, quality metrics, and service level agreements to evaluate provider engagement initiatives.
Identify and manage risks associated with process changes, implement mitigation strategies, and communicate or escalate issues to stakeholders.
Report provider APM program progress and oversight status to stakeholders.
Ensure provider performance engagement milestone deliverables are completed for each project phase.
Maintain internal strategic alignment when prioritizing projects by following the established RACI document and ensuring appropriate stakeholder engagement.
Participate in Provider Oversight Committee meetings with internal business owners and providers.
Provide leadership guidance to support staff career growth.
Oversee day-to-day staff activities to ensure department goals are achieved.
Manage department staff objectives and prioritization to align with market and corporate goals.
Perform other job-related instructions as requested.