Sr. Network Performance Professional

CarePlus Health Plans Inc

Washington, US
Base: $78,400 - $107,800 py; bonus: eligible for i...
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Medicare risk adjustment experience
Ncqa hedis measures knowledge
Cms star rating system expertise
** CarePlus Health Plans, Inc. is seeking a Senior Network Performance Professional to enhance provider performance and support their mission of delivering high-quality healthcare. The ideal candidate will have experience in healthcare provider relations, Medicare Risk Adjustment, and strong communication skills. This hybrid role involves strategic initiatives and relationship-building with healthcare providers. **

Job Summary

  • This role plays a pivotal part in enhancing provider performance and advancing the mission to deliver high-quality healthcare through strategic initiatives.
  • Candidates will serve as an expert on Stars/Quality programs, educating physician groups on HEDIS, patient safety, and patient experience metrics.
  • The position offers competitive benefits including medical, dental, vision, 401(k) retirement savings, and paid time off to support whole-person well-being.

Matching Summary

Match Score: 75

** CarePlus Health Plans, Inc. is seeking a Senior Network Performance Professional to enhance provider performance and support their mission of delivering high-quality healthcare. The ideal candidate will have experience in healthcare provider relations, Medicare Risk Adjustment, and strong communication skills. This hybrid role involves strategic initiatives and relationship-building with healthcare providers. **

Salary

Base: $78,400 - $107,800 per year; Bonus: Eligible for incentive plan based on company/individual performance; Benefits: Medical, dental, vision, 401(k), paid time off

Skills & Requirements

Must-have

  • Medicare Risk Adjustment experience
  • NCQA HEDIS measures knowledge
  • CMS Star Rating System expertise
  • Provider relationship building skills
  • Microsoft Office proficiency

Nice-to-have

  • Strong presentation skills for leadership
  • Experience with interoperability initiatives
  • Process and quality improvement focus
  • Ability to drive consumer experience
  • Coaching and review capabilities

Key Requirements

  • Bachelor's degree in business, finance, or healthcare administration
  • Experience with Medicare Risk Adjustment and/or medical coding
  • Understanding of PQA Measures and CAHPS/HOS survey systems
  • Must reside in Washington or Oregon
  • Willingness to travel minimum 25% within region

Work Rights

Not specified

Tailored Resume

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