Value-Based Care and Provider Performance Management
hace 17 horas
Brooklyn
Work Location: Brooklyn, NY About NSIPA: Network Solutions IPA (NSIPA) is a leading New York–based Independent Practice Association with a diverse, multi-specialty provider network. The organization has grown to more than 600 physician members, serving over 100,000 patients across New York City, Nassau, Suffolk, and Westchester counties. We are committed to helping independent providers succeed in the transition to value-based care. Through strategic partnerships, operational support, and robust payer relationships, NSIPA delivers the tools, resources, and expertise that allow practices to grow, perform, and succeed in today’s complex healthcare landscape without sacrificing independence. We achieve this by collaborating with payers to deliver Quality Incentive Programs, Shared Savings arrangements, and Risk-Based Contracts. Contracted with over 21+ Payers for over 600+ Providers. NSIPA provides a comprehensive suite of services, including credentialing and network operations, provider engagement, and contracting; care coordination and member outreach; and provider-and patient centered programs. As part of New York State’s 1115 Medicaid Waiver, NSIPA plays a key role in identifying, screening, and addressing health-related social needs by connecting Medicaid members to community-based resources and care supports. These services are designed to strengthen provider efficiency, address health related social care needs, and advance value‑based care and population health opportunities. Recognized as one of New York’s fastest‑growing IPAs, NSIPA supports improved clinical outcomes, enhanced provider performance, and cost savings for payers through its robust infrastructure and operational expertise. Position Overview: The Manager of Value-Based Care & Provider Performance plays a key role in advancing Network Solutions IPA’s (NSIPA) mission to support independent providers in delivering high-quality, cost-effective care. This role blends provider engagement, value-based performance management, and quality improvement across NSIPA’s multi-payer network. This individual will collaborate with providers, payers, and internal teams to drive improvements in quality outcomes, utilization, and population health performance. The ideal candidate is relationship‑driven, analytically strong, and comfortable navigating both strategic and operational aspects of value-based care programs Roles & Responsibilities: · Serve as the primary point of contact for a designated panel of providers, fostering strong, trust‑based relationships and ensuring high satisfaction · Conduct regular in‑person provider visits, delivering program updates, performance results, and operational support. · Lead provider onboarding and orientations, ensuring practices understand NSIPA workflows, value‑based care requirements, and available resources · Communicate performance expectations, care gap strategies, documentation standards, and quality improvement initiatives clearly and effectively · Deliver regular performance reports (quality, utilization, cost, care gaps) and translate data into actionable recommendations for providers · Analyze provider performance trends using claims, EHR, and payer data to identify risks, opportunities, and areas needing intervention · Support underperforming providers through hands‑on coaching, workflow enhancements, and targeted quality improvement plans · Implement and support initiatives tied to HEDIS, QARR, CAHPS, medication adherence, and transitional care requirements · Collaborate with Data & Analytics to develop provider-friendly insights and ensure accurate, timely performance monitoring · Facilitate access to EMRs, coordinate medical record requests, and support documentation accuracy for quality and audit readiness · Support population health and care coordination programs, including outreach initiatives and member engagement strategies · Participate in payer Joint Operating Committees and support contractual performance activities · Maintain strong cross-functional collaboration with internal teams (Quality, Care Coordination, Network Operations, Contracting, IT, etc.) to ensure smooth execution of provider and organizational initiatives · Assist in the development of educational materials, job aids, presentations, and resources related to quality, value-based care, and provider performance · Assist with special projects such as chart audits, EMR integrations, performance deep dives, population health initiatives, and events · Contribute to provider network development efforts, including identifying recruitment opportunities and supporting relationship-building strategies · Ensure compliance with payer requirements, regulatory standards, and NSIPA quality and performance expectations Skills & Competencies: · Strong communication, relationship management, and provider‑facing skills · Ability to interpret data and translate insights into operational recommendations · Excellent organizational, project management, and problem‑solving abilities · Highly self‑directed with the ability to manage competing priorities · Proficiency in Microsoft Office; experience with data visualization tools preferred · Collaborative mindset, professionalism, and strong emotional intelligence Required Qualifications: · Bachelor’s degree in healthcare administration, public health, nursing, business, or related field (master’s preferred) · 3–5+ years of experience in value-based care, provider engagement, quality improvement, managed care, or network operations · Experience working in an IPA, MSO, health plan, or provider organization preferred · Familiarity with HEDIS/QARR/CAHPS measures and population health workflows strongly preferred · Experience with EMRs, performance reporting systems, and population health analytics platforms (e.g., Tableau, Garage) Why Join NSIPA? · High-impact leadership role with direct influence on organizational strategy. · Opportunity to shape the future of value-based care across diverse populations. · Collaborative, mission-driven environment focused on improving patient outcomes. · Visibility, growth, and the ability to build and scale performance programs. Physical Demands: The physical demands described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable qualified individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to stand; walk; sit for extended periods of time; use hands to finger, handle, or feel; make precisely coordinated movements of the fingers of one or both hands to grasp, manipulate, or utilize computer equipment; reach with hands and arms; and talk or hear. The employee must occasionally lift and/or move up to 20 pounds. Specific vision abilities required by this job include close vision, distance vision, ability to adjust focus and ability to match or detect differences between colors, including shades of color and brightness. EEO Statement: • NSIPA is an equal opportunity employer committed to diversity and inclusion. We encourage applications from all qualified individuals regardless of race, color, religion, gender, sexual orientation, age, national origin, disability, or veteran status.