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Director, Network Performance and Strategy – Preferred Experience in Managed Care
CareSource. Provide strategic leadership for the enterprise Network Performance and Strategy function across markets and lines of business .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in network performance management, healthcare strategy, and provider performance analytics, with a strong focus on developing standardized frameworks and leveraging advanced analytics and AI for strategic decision-making. Proven ability to lead cross-functional teams and drive measurable business impact across diverse healthcare markets.
Highest-signal resume keywords
Network Performance ManagementHealthcare StrategyProvider Performance AnalyticsExecutive LeadershipChange Management
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Advanced AnalyticsNetwork OptimizationValue-Based CareReimbursement StrategiesHealthcare EconomicsMedical Cost ManagementData-Driven Decision-MakingMarket Strategy DevelopmentProvider Performance EvaluationHealthcare Analytics
Soft Skills
Executive CommunicationRelationship ManagementStrategic Problem-SolvingCross-Functional InfluenceOrganizational Leadership
Tools & Technologies
Decision-Support ToolsAutomationAI PlatformsProprietary Platforms
Industry Keywords
Managed CareMedicaid Managed CareMedicare AdvantageNetwork AdequacyUtilization ManagementHealthcare AdministrationBusiness AnalyticsPublic Health
About the role
Key responsibilities & impact- Provide strategic leadership for the enterprise Network Performance and Strategy function across markets and lines of business
- Develop standardized frameworks for evaluating provider performance, network adequacy and access, utilization, affordability, leakage/OON utilization, quality, contracting performance, and other network measures
- Translate network performance intelligence into strategies improving market performance, affordability, quality, network adequacy, growth, and competitive positioning
- Advise network leadership using enterprise benchmarks, insights, and scalable solutions
- Establish enterprise standards and methodologies for network performance management
- Lead development of network performance reporting, analytics, decision-support tools, automation, AI, and proprietary platforms
- Partner with Medical Economics and Actuarial leadership on network performance methodologies and analytical models
- Partner with Value-Based Contracting leadership on provider segmentation, performance insights, and VBC strategy
- Partner with Network Contracting on contracting priorities, provider targeting, reimbursement strategies, and network optimization
- Identify and prioritize enterprise network opportunities and develop business cases
- Oversee deployment of network performance capabilities across markets, including adoption, change management, and measurable business impact
- Evaluate emerging technologies, data sources, vendors, and industry practices
- Develop and manage the team's operating plan, talent strategy, priorities, and resource allocation
- Represent Network Performance & Strategy with executive leadership and cross-functional stakeholders
- Establish accountability for measurable outcomes and evaluate team impact on network performance and business objectives
- Perform other job-related duties as requested
Requirements
What you’ll need- Bachelor's degree in healthcare administration, business, analytics, economics, public health, or related field required
- Equivalent years of relevant work experience may be accepted in lieu of required education
- Ten (10) years of progressive experience in managed care, healthcare strategy, network management, provider performance, medical economics, healthcare analytics, or related areas required
- Five (5) years of experience in leadership roles required
- Experience in Medicaid managed care and/or Medicare Advantage preferred
- Experience with network optimization, provider performance, value-based care, reimbursement, or medical cost management preferred
- Demonstrated understanding of health-plan network strategy, provider performance, healthcare economics, and managed-care operations
- Skilled in using advanced analytics, AI, or technology-enabled operating models
- Skilled in leading enterprise capabilities across a geographically dispersed health-plan organization
- Familiarity with operating across multiple markets, business units, or lines of business
- Strong executive communication, relationship management, and strategic problem-solving skills
- Skilled in enterprise network strategy
- Skilled in network performance management
- Familiarity with healthcare economics
- Executive leadership skills
- Cross-functional influence skills
- Skilled in developing and analyzing Market strategy
- Knowledgeable in provider performance
- Change management skills
- Data-driven decision-making skills
- Organizational leadership skills
- No licensure or certification required
- Up to 25% regular travel may be required
Benefits
Comp & perks- Bonus tied to company and individual performance may be available
- Substantial and comprehensive total rewards package
- Total well-being support
- Remote work arrangement