About The Position

Leads and oversees key provider relationships across the region. Drives network performance, value-based outcomes, and membership growth through strategic provider contracting, performance management, and collaboration with home care providers and NYS Social Care Networks. Brings health plan experience, strong organizational skills, and a creative, solution-oriented approach to complex provider and market challenges.

Requirements

  • Bachelor's Degree in healthcare administration, business, or related field, or equivalent experience required
  • Minimum 5 years of experience in provider relations, contracting, network management, or performance management within a health plan or managed care environment required
  • Demonstrated experience working with home care services, community-based providers, and/or long-term services and supports (LTSS) required
  • Experience supporting membership growth through provider network expansion, market development, or strategic partnerships required
  • Strong understanding of value-based contracting, quality metrics, cost and utilization, and provider performance improvement required
  • Highly organized with strong project management and prioritization skills required
  • Creative problem solver with the ability to operate effectively in complex, multi-stakeholder environments required
  • Excellent communication and relationship-building skills, with the ability to influence provider and executive leadership required
  • Proficiency in Microsoft Office, including Excel and PowerPoint required

Responsibilities

  • Ensures alignment with organizational goals, regional growth priorities, and market expansion initiatives.
  • Serves as the primary relationship manager for external vendor relationships, key provider partners, including hospital systems, home care agencies, FQHCs, IPAs, multi-specialty groups, and community-based organizations.
  • Oversees performance-based and value-based contracts, monitoring quality, cost, utilization, access, and network performance outcomes.
  • Partners with internal growth, marketing, and operations teams to support membership growth through network expansion, provider engagement, and market readiness.
  • Develops and executes strategies to improve provider performance, member outcomes, provider retention, and network adequacy, with a focus on home care and community-based services.
  • Builds and maintains strong relationships with NYS Social Care Networks and community partners to support integrated, whole-person care delivery.
  • Identifies, escalates, and resolves provider issues in collaboration with internal stakeholders, creating sustainable process improvements.
  • Coordinates and participates in Joint Operating Committee (JOC) and other provider performance and growth-related meetings.
  • Partners cross-functionally with Quality, Finance, Clinical, Operations, and Growth teams to execute network and market strategies.
  • Analyzes performance, utilization, and growth data to inform leadership decisions and provider engagement strategies.

Benefits

  • Referral bonus opportunities
  • Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays
  • Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
  • Employer-matched retirement saving funds
  • Personal and financial wellness programs
  • Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
  • Generous tuition reimbursement for qualifying degrees
  • Opportunities for professional growth and career advancement
  • Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities
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