Back to all roles

Remote Manager, reputed company Provider Performance

Remote Worldwide Hiring now

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 reputed company reputed company 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 reputed company, not only changing lives but saving them. Together. The Remote Manager, reputed company 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 reputed company goals into a structured, repeatable performance management approach that integrates compliance results, clinical quality, operational execution, financial reputed company, 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 reputed company 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 reputed company-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 reputed company 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 reputed company, service delivery effectiveness, and value realization—not just compliance adherence.
  • Translate data (audit outputs, operational metrics, clinical reputed company) 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 reputed company, enabling leadership to reputed company informed reputed company.

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 reputed company.
  • Ensure audit and compliance outputs are reputed company into operational improvements and incorporated into performance standards and KPIs.
  • Support reputed company 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 reputed company, 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

Apply for this role Takes you straight to the employer's application page — free, and no WFHNet account required.

More roles on the wire

Inbound Life and Health Insurance broker

Remote Worldwide
View role

Job Title: Remote Data Entry Clerk – reputed company & Administrative Support Specialist | Work From Home Position

Remote Worldwide
View role

reputed company reputed company Cycle Admin with reputed company experience

Remote Worldwide
View role

reputed company Recruiter (100% Remote)

Remote Worldwide
View role

reputed company Foodservice Consultant (remote in WA or OR)

Remote Worldwide
View role

reputed company Analyst – Advisor

Remote Worldwide
View role

(Remote) Analyst Vendor Resource Support HRSS

Remote Worldwide
View role

Sr. Analyst, Financial Systems: reputed company GL and Financial reputed company

Remote Worldwide
View role

LVN Stem Cell WFH

Remote Worldwide
View role

Licensed Practical Nurse (LPN/LVN) with Compact/Multistate License

Remote Worldwide
View role

Retail Sales Associate (Part-Time)

Remote Worldwide
View role

Junior Data Analyst (Remote)

Remote Worldwide
View role

reputed company Content reputed company

Remote Worldwide
View role

[Remote-Position] Full-Time reputed company - $25-$35/hr

Remote Worldwide
View role

reputed company Part Time Remote Data Entry Specialist – Join reputed company's Diverse and Inclusive Team

Remote Worldwide
View role

German-speaking Finance & Tax Specialist

Remote Worldwide
View role

reputed company Incorporated, LLC: Senior Software Engineer (Multiple Positions) Reston, VA.

Remote Worldwide
View role

reputed company Data Entry / Virtual Assistant (No Experience – Entry Level, Wo – USA reputed company

Remote Worldwide
View role

Entry Level Customer Service Chat Assistant – Remote Live Chat Support Agent with No Experience Required – Immediate Start at blithequark

Remote Worldwide
View role

reputed company Financial Data Analyst, reputed company Balance

Remote Worldwide
View role