Manager, Provider Performance Engagement

CareSource

. Oversee performance engagement activities with internal and external partners .

Posted 10/14/2026full-timeRemote • Ohio • United StatesMid-LevelSenior💰 $83,000 - $132,800 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing provider performance engagement activities and ensuring compliance with regulatory standards. Proficient in project management processes and skilled in data analysis to improve health outcomes and cost efficiency.

Highest-signal resume keywords

Provider Performance EngagementRegulatory ComplianceProject ManagementData AnalysisLeadership Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Data AnalysisProject ManagementHealthcare Payer-Provider IntegrationQuality Metrics ManagementAlternative Payment Model (APM) KnowledgePatient Centered Medical Home (PCMH) ConceptsFinancial ROI ManagementProcess DevelopmentRegulatory Standards KnowledgeMicrosoft Office Proficiency

Soft Skills

Communication SkillsInterpersonal SkillsCollaboration SkillsEmotional IntelligenceTime Management

Tools & Technologies

Microsoft ProjectMicrosoft WordMicrosoft Excel

Industry Keywords

State Medicaid ProgramsMedicareQuality AccreditationODMCMSNCQAURAC

About the role

Key responsibilities & impact

Oversee performance engagement activities with internal and external partners
Improve health outcomes and total cost of care by aligning provider interventions with customized APM engagement plans
Conduct internal and external meetings to establish and execute provider performance engagement plans
Manage customized provider plans supporting key quality metrics and positive outcomes
Manage process development for provider onboarding and oversight
Ensure compliance with state, federal, and regulatory body requirements
Develop and maintain departmental policies and procedures for oversight of contracted providers in an Alternative Payment Model
Analyze, update, and modify procedures to improve engagement processes
Review and incorporate data analysis for program metrics, outcome measures, results, and savings opportunities
Support and manage financial ROI, quality metrics, and service level agreements
Identify and manage risks associated with process changes, implement mitigation strategies, and communicate or escalate to stakeholders
Report provider APM program progress and oversight status to stakeholders
Ensure provider performance engagement milestone deliverables are completed for each project phase
Maintain strategic alignment when prioritizing projects using the established RACI document
Participate in Provider Oversight Committee meetings with internal business owners and providers
Provide leadership guidance to support staff career growth
Oversee day-to-day staff activities to achieve department goals
Manage department staff objectives and prioritization in alignment with market and corporate goals
Perform other job-related instructions as requested

Requirements

What you’ll need

Bachelor's degree or equivalent years of relevant work experience is required
Minimum of five (5) years of experience working collaboratively with external Health Partners is required
Familiarity with the healthcare field and experience with payer-provider integration is required
Master's degree in business or health related field is preferred
Minimum of one (1) year leadership/management experience preferred
Proficient in Microsoft Office tools, including Project, Word, and Excel
Thorough understanding of project management processes, techniques and tools
In-depth knowledge of regulatory and quality standards and measures, including State Medicaid programs, Medicare and Quality Accreditation (e.g., ODM, CMS, NCQA, URAC, etc.)
In-depth knowledge of Patient Centered Medical Home (PCMH) concepts and processes
Ability to communicate before individuals, groups, and executive leadership
Proven ability to effectively interact with all levels of management within the organization
Strong analysis and collaboration skills
Exceptional emotional intelligence
Excellent written and verbal communication skills
Strong interpersonal and relationship building skills
Ability to work independently and within a team environment
Ability to multi-task and prioritize work to meet project deadlines
Effective listening and critical thinking skills
Time management skills
Customer service oriented
Decision making/problem solving skills
Excellent planning, negotiating and influencing skillset
Influenza vaccination required during Influenza season as a condition of continued employment

Benefits

Comp & perks

Bonus tied to company and individual performance
Comprehensive total rewards package
Reasonable accommodations for qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law
Annual Influenza vaccination requirement covered as a condition of continued employment
General office environment with flexibility to sit or stand