Provider Network Performance Manager
About The Position
The Provider Network Performance Manager drives provider performance across the Oregon and Washington markets by partnering with providers to improve cost, quality, access, and overall network performance. The role combines provider performance management, data analysis, relationship management, and contracting strategy. It uses performance data to identify opportunities, lead provider conversations, develop improvement plans, and influence provider behavior toward measurable results. The position owns performance management for assigned providers, including physicians, medical groups, health systems, and other providers. It leads regular performance reviews and Joint Operating Committees, builds accountable partnerships, analyzes data and translates it into actionable recommendations, and supports contracting and network strategies that improve outcomes. The role partners cross-functionally to improve network efficiency, quality, access, and regulatory compliance. Approximately 30–40% travel within the assigned market is expected to support provider meetings, relationship building, and market presence. The position must be based in Washington or Oregon.
Requirements
- At least 5 years of experience in managed care, a health plan, or a similar healthcare environment.
- At least 5 years of direct provider-facing experience.
- Demonstrated experience improving provider performance across cost and/or quality metrics.
- Strong analytical skills and the ability to translate data into action.
- Strong provider relationship management, communication, and influencing skills.
- Ability to work independently, solve complex problems, and drive results.
- Must be located in Washington or Oregon.
Nice To Haves
- Experience negotiating provider contracts, including with physician groups and/or health systems.
- Experience with value-based or risk-based payment models.
- Experience in provider performance, network optimization, or healthcare analytics.
Responsibilities
- Own performance management for assigned providers across cost, quality, access, and key network metrics.
- Identify performance gaps, root causes, and opportunities for improvement.
- Develop and execute targeted provider performance improvement plans.
- Monitor results and adjust strategies to drive sustained improvement.
- Serve as a primary performance partner for assigned physicians, medical groups, health systems, and other providers.
- Lead regular provider performance reviews and Joint Operating Committees (JOCs).
- Build strong provider relationships while creating clear accountability for performance expectations and outcomes.
- Partner with providers to resolve performance issues and remove barriers to improvement.
- Analyze financial, operational, quality, and provider performance data to identify trends and opportunities.
- Use reporting systems, dashboards, and AI-enabled tools to generate insights.
- Translate complex data into clear recommendations and actionable strategies.
- Provide leadership with visibility into performance trends, risks, and opportunities.
- Support contract negotiations and renegotiations, where applicable, to align provider incentives with performance goals.
- Apply fee-for-service, value-based, and risk-based models to support improvements in cost and quality.
- Evaluate provider and network opportunities through a performance lens.
- Partner cross-functionally to improve network efficiency, quality, access, and regulatory compliance.
Benefits
- Employer-sponsored health, dental, and vision plans with low or no premium.
- Generous paid time off.
- $100 monthly mobile or internet stipend.
- Stock options for all employees.
- Bonus eligibility for all roles excluding Director and above; commission eligibility for Sales roles.
- Parental leave program.
- 401(k) program.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
No Education Listed
