Program Director – Provider Performance

Program Director – Provider Performance

Requirements

• Bachelor’s degree in business or health administration (Master’s preferred) or related field
• 10+ years of experience in program management or equivalent combination of education and experience
• Experience driving transformation in programmatic innovation, alternative payment model development, network & product strategy, and strategic implementation
• Prior experience in implementation and management of provider evaluation methodologies/programs with either payers or provider organizations

Responsibilities

• Accountable for planning, prioritization, implementation, and management of Cambia’s provider performance framework project and related initiatives internally and externally to achieve enterprise success criteria
• Work closely with cross-functional teams, including Network Management, Actuarial, Digital, Product, and other business stakeholders
• Continually evolve and optimize the workflows required for operational excellence across the project internally and externally; create, document, and socialize program governance and best practices, including training materials and education
• Build, cultivate, and leverage strong partnership with vendor for ongoing reliability and joint development
• Create and maintain effective executive reporting to represent overall project health, mitigate risk, and inform strategic decisions
• Support Network Innovations programs team in initiatives to impact quality and cost stewardship of our members
• Provides thought leadership, systems thinking, design thinking and industry expertise to the development of strategic programs, horizontally integrating with innovation and operations across the organization

Preferred Qualifications

• Demonstrated ability to develop, manage, and sustain cross functional relationships internally and externally
• Knowledge of health plan network dynamics, alternative payment models, and forward-thinking healthcare trends
• Experience in the area of project coordination and management
• Excellent verbal and written communication skills. Ability to communicate effectively, both orally and in writing, with individuals and groups, regarding complex issues and initiatives
• Ability to adapt quickly to changing market conditions, enterprise needs, and technical advancements