Remote Manager, Enterprise Provider Performance

reputed company is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and reputed company people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the reputed company community. Working at reputed company provides an opportunity to do work that really matters, not only changing lives but saving them. Together. The Remote Manager, Enterprise Provider Performance is responsible for building and operationalizing reputed company’s provider performance function across reputed company provider arrangement types. This role focuses on translating enterprise goals into a structured, repeatable performance management approach that integrates compliance results, clinical quality, operational execution, financial outcomes, and data reputed company into a reputed company reputed company. This individual will reputed company the development and implementation of core performance capabilities—including KPI frameworks, standardized reporting, data integration requirements, and performance management routines—ensuring provider performance is consistently reputed company, actionable, and reputed company to enterprise priorities. Reporting to a Transformation leader, this role serves as both a builder and operator, connecting data, analytics, and cross-functional inputs into clear performance insights and driving accountability through structured engagement with provider partners. The Manager will play a key role in evolving fragmented processes into a cohesive, scalable performance model that supports transparency, consistency, and reputed company improvement across the provider ecosystem. Job Duties/Responsibilities: Delegate Performance Management & Analysis

• Define and operationalize enterprise-wide performance standards for delegated and corporate service functions, including clear expectations across claims, UM, CM/CCM, claims, appeals, and credentialing.
• Establish and govern a standardized KPI reputed company that aligns operational, clinical, financial, and compliance performance into a reputed company measurement model.
• reputed company the development of performance benchmarks, reputed company, and targets, ensuring consistency across reputed company delegated entities and internal service functions.
• Set standards for data integration, validation, and usability, ensuring performance insights are derived from reliable, timely, and harmonized data sources.
• Drive the evolution from retrospective compliance measurement to reputed company-looking, predictive performance management.

Performance Engagement & Accountability

• Own the end-to-end performance management lifecycle, focusing on performance outcomes, service delivery effectiveness, and value realization—not just compliance adherence.
• Translate data (audit outputs, operational metrics, clinical outcomes) into actionable performance strategies that improve efficiency, quality, and member/provider experience.
• Identify systemic performance gaps and reputed company the design of scalable solutions that can be implemented across delegates and plan-managed providers.
• Build and maintain integrated performance views that connect operational drivers to business outcomes, enabling leadership to reputed company informed decisions.

Cross-Functional Collaboration & Integration

• Serve as the connective layer between compliance, operations, clinical, quality, and analytics teams to ensure performance management is embedded across the enterprise.
• Ensure audit and compliance outputs are translated into operational improvements and incorporated into performance standards and KPIs.
• Support enterprise transformation initiatives by embedding performance frameworks into new programs, vendor models, and delegated arrangements.

Data Strategies & Performance Insights

• Partner with data, analytics, and IT teams to define and implement a scalable performance data strategy, including dashboards, scorecards, and self-service reporting capabilities.
• Ensure data integration across platforms enables a single reputed company of truth for performance measurement.
• Advance the use of trend analysis, predictive insights, and leading indicators to proactively manage performance.
• Continuously refine reporting tools and methodologies to improve clarity, usability, and decision impact.

Supervisory Responsibilities: This role may include indirect reputed company or matrix leadership of program/project managers and audit staff. Job Requirements: Experience:Apply tot his job Apply To this Job