The Staff Vice President, Regional Engagement leader will play a pivotal role in ensuring optimal performance of providers within a specified region encompassing multiple local markets. Reporting to the Vice President, Provider Engagement and Governance, this position requires a strategic mindset, exceptional leadership skills, and a comprehensive understanding of provider management, performance, and engagement. This role will be responsible for developing, executing, and tracking initiatives aimed at enhancing provider performance across key indicators such as quality, cost-effectiveness, and clinical efficiency tailored to fit the needs of individual providers.

• Develop and direct the execution of key strategic initiatives to support local markets, recommending opportunities for increasing business value.
• Lead the development of strategic operational plans and monitor implementation, including large-scale transformation projects.
• Collaborate with health plan leaders to facilitate system-wide implementations and ensure continuous improvement from pilot to full-scale implementation.
• Establish and drive key performance indicators (KPIs) and interpret data to improve provider performance
• Partner with local market and quality teams to ensure providers achieve high-quality results consistent with QARR and HEDIS measures.
• Utilize data analysis to identify areas for service level improvements and develop specific actions based on findings.
• Foster direct collaboration between shared service stakeholders and the health care plan to reduce rework, streamline administration, and reduce costs for all constituents.
• Manage and develop local market relationships, providing high-touch and responsive servicing of critical providers through shared service resources
• Collaborate with all functions within the company to develop services and processes that streamline resolution of provider issues.
• Partner with health plans to monitor provider performance of risk arrangements for multiple product lines.
• Strategic Initiatives and Business Development
• Lead the development of provider-related corporate initiatives, business plans, strategies, and goals.
• Analyze industry trends and new technologies to maintain cutting-edge services and capitalize on emerging opportunities.
• Analyze and interpret facts/results using research methods and techniques.
• Prepare meaningful, actionable reports and develop routine communication of status via project plans, dashboards, presentations, or other tools as appropriate.
• Escalate issues, as appropriate, to ensure timely resolution and on-time project delivery.
• Enhance and leverage analytics, member demographics, and healthcare facility usage patterns to identify efficiency opportunities.
• Collaborate with operational areas and appropriate vendors on initiatives supporting provider performance and financial efficiencies.
• Perform special projects as assigned or directed.
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience

• Bachelor’s Degree healthcare administration, business, or related field required
• Master’s Degree preferred
• 6+ years in a leadership role within provider management or healthcare strategy required
• In-depth knowledge of provider engagement, network management, and performance improvement methodologies required