Provider Utilization Lead - VA Program
About The Position
Do you crave a career that truly makes an impact in people’s lives? Do you thrive on problem-solving and finding solutions? Join a dedicated, tight-knit team that creates an immediate and meaningful impact every day Leidos QTC Health Services is seeking a Provider Utilization Lead to support the VA Program. You will be responsible for developing, implementing, and overseeing provider utilization strategies to ensure high-quality, cost-effective care across the network. This role analyzes utilization trends, reviews processes, and collaborates with the operations team and provider management teams to optimize resources and ensure we meet the customer metrics.
Requirements
- Bachelor’s degree from an accredited college in a related discipline, or equivalent experience/combined education
- Minimum 7 years’ experience of relevant professional experience
- Must have experience interfacing with diverse staff and driving results
- Proficient in Microsoft Office programs.
- Excellence with Microsoft Excel (Ability to create pivot tables) and experience with Tableau is desired
- Knowledge/experience with provider or healthcare management
Nice To Haves
- Excellent verbal, presentation and written communication skills
- Strong planning, problem-solving, and analytical skills
- Demonstrated ability to work independently, take initiative and be self-motivated
- Must possess the ability and flexibility to work to meet deadlines and customer expectations
- Ability to effectively manage competing priorities with a sense of urgency
- Proficiency with software applications such as MS Office, Power Point, and PRM.
- Must present and communicate in a professional manner
- Critical thinking skills with problem solving expertise
- Possess proven analytical/problem solving solutions for the provider network and drill down of aged/cluster SAS
- Experience in developing and executing territory strategies
- Possess organizational and follow up skills, with attention to detail
- Must have the ability to work various hours of the day and weekends as needed
Responsibilities
- Responsible for driving strategic initiatives in collaboration with stakeholders and support teams.
- Monitor and evaluate the utilization patterns to determine the appropriate provider modalities and ensure pending exams have a quick solution.
- Utilize data to identify utilization strategies and including over and under-utilization.
- Assess provider utilization through cost, quality, and utilization metrics
- Develop a VA provider dashboard and share key metrics with Enabling Operations and VA Operations Leadership
- Work with provider management and Operations to address trends, improve efficiency, and resolve utilization concerns.
- Recommend and implement network improvements to support critical business initiatives.
- Serve as a key liaison between operations, provider management, and clinic operations
- Participate in interdisciplinary meetings and quality improvement initiatives
- Analyze large data sets to identify utilization trends, risk areas, and opportunities for improvement
- Prepare reports for leadership summarizing findings, metrics, and recommendations
- Support forecasting, planning, and performance improvement projects through data-driven insights
- Maintain documentation and audit readiness for internal and external reviews
- Preform other duties and responsibilities as assigned
Benefits
- Employment benefits include competitive compensation, Health and Wellness programs, Income Protection, Paid Leave and Retirement.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
