Manager, Provider Performance Management

Manage the performance governance aspects of provider services contracts. These activities include :

• Enforce compliance with the contractual SLAs and deliverables.
• Review and validate performance reporting.
• Capture potential value leakage and / or service level penalties.
• Coordinate implementation of SLA reporting automation.
• Generate dashboards and reports for executive level briefing.

Develop and measure provider network performance metrics and objectives, such as :

• Cost, quality, and accessibility reporting.
• Network reporting supportive of open enrollment and RFP's.

Ensure all regulatory network requirements are measured and reported according to listed requirements, such as :

• ACA, QUEST, Medicare, HMSA
• Oversee data analysis functions that support contract negotiations and fee reviews.

Oversee out of network provider access strategies including :

• Single case agreements
• Network access partner solutions
• Perform all other miscellaneous responsibilities and duties as assigned or directed.

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