LTSS Provider Network Performance Manager
Clayton, MO 63105
- Develop, manage and support high performing provider network performance for Medicaid Long Term Services and Supports (LTSS) including metrics, improvements, including analytics, reporting, training and education.
- Leverage various tools and solutions to support effective provider engagement activities.
- Collaborate with health plan leaders and LTSS product leaders to review LTSS network performance, including quality, cost, care gaps, and risk adjustment gaps, and develop improvement plans.
- Determine analytic reporting needs and provide training and support on network performance applications and reporting tools.
- Lead provider profiling and network performance analytic support functions and provide support to health plans and other stakeholders.
- Monitor and measure provider Health Benefits Ratio (HBR), quality, unit cost and utilization trends and identify and implement network improvement opportunities.
- Support existing application tools and solutions, identify and recommend technical enhancements to improve outcomes and functionality.
- Bachelor s degree in Business, Economics, Finance, Healthcare or related field or equivalent experience.
- 4+ years of contracting, health care reimbursement, provider contract modeling or quality measurement experience.
- Prior experience building and managing relationships with health care providers preferred.
For more information about this position, please contact us at 877-782-3334.