The JobThe
Director of Market Performance is responsible for developing, operating, and continuously improving the provider performance management framework across the enterprise. This role partners with subject matter experts, market leaders, Provider Relations, technology, analytics, and operational teams to define key performance indicators, generate actionable insights, build performance improvement playbooks, and drive execution strategies that improve quality, member experience, affordability, coding accuracy, access, and provider performance outcomes.
The
Director serves as a key leader in the Market Performance Center of Excellence, enabling scalable provider engagement strategies, operational transformation initiatives, and performance improvement programs across all markets.
You Will- Lead the development, maintenance, and continuous improvement of enterprise-wide provider performance playbooks, frameworks, and execution standards across all markets.
- Partner with subject matter experts and business leaders to define, operationalize, and monitor key performance indicators across quality, cost, growth, member experience, access, risk adjustment, coding accuracy, and provider performance.
- Design scalable methodologies to identify performance opportunities, document interventions, track outcomes, and measure provider group and market-level performance improvement.
- Translate data, analytics, and performance insights into actionable provider interventions that improve quality outcomes, Stars performance, affordability, coding accuracy, access, and member experience.
- Create standardized performance improvement tools, executive-ready reporting, provider-facing materials, scorecards, dashboards, training content, and engagement resources.
- Establish governance processes to monitor performance trends, identify risks, evaluate intervention effectiveness, and recommend corrective actions across provider partners and markets.
- Serve as the business lead for operational initiatives that impact provider performance, including encounter submission onboarding, gap closure processes, provider training, vendor management, and audit reporting frameworks.
- Drive implementation of innovative provider performance and operational transformation programs, including advanced coding accuracy initiatives, and technology-enabled process improvements.
- Lead change management and training efforts to support adoption of provider engagement standards, performance improvement programs, reporting practices, and market performance strategies.
- Design and implement the long-term provider service model strategy, including provider-facing support functions, shared service models, centralized intake, case routing, escalation processes, CRM strategy, provider portals, and service model enhancements.
- We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.
- Actively support the achievement of SCAN's Vision and Goals.
- Other duties as assigned.
Your Qualifications- Bachelor's Degree or equivalent experience in Business Administration, Health Care Administration, Public Health, Finance, Operations, Analytics, or a related field.
- Graduate or Advanced Degree or equivalent experience.
- 7+ years of progressively responsible experience in provider performance, health plan operations, provider relations, value-based care, population health, risk adjustment, quality improvement, analytics, or operational transformation required.
- Prior leadership experience developing enterprise programs, performance frameworks, provider engagement strategies, or cross-functional initiatives required.
- Strong knowledge of health plan operations, provider performance management, value-based care, quality improvement, Stars performance, risk adjustment, and provider engagement strategies.
- Ability to translate complex data, analytics, and performance insights into actionable strategies, executive-ready reporting, and operational improvement plans.
- Excellent verbal and written communication skills, including the ability to develop provider-facing materials, executive presentations, dashboards, playbooks, and training content.
- Ability to define cross-functional KPIs, design scalable processes, governance structures, service models, and performance improvement frameworks across multiple markets.
- Strong program management, analytical, problem-solving, decision-making, and organizational skills.
- Advanced relationship management, stakeholder engagement, and partnership-building capabilities.
- Ability to manage competing priorities and lead complex initiatives in a fast-paced, matrixed environment.
- Ability to promote innovation, continuous improvement, and adoption of new technologies, including artificial intelligence-enabled solutions.
- Advanced technical skills are required with Microsoft Office Suite, Visio, and SQL.
Experience Preferred: - Experience supporting Medicare Advantage, managed care, value-based care, provider network performance, or health plan operations preferred.
- Experience leading enterprise-wide performance improvement programs, provider engagement strategies, shared service models, or technology-enabled operational transformation initiatives preferred.
- Experience with dashboards, scorecards, provider reporting, CRM platforms, provider portals, data analytics tools, or performance management systems preferred.
What's in it for you?- Base salary range: $147,900 to $214,030 per year
- Work Mode: Mostly Onsite
- An annual employee bonus program
- Robust Wellness Program
- Generous paid-time-off (PTO)
- Eleven paid holidays per year, plus 1 floating holiday, plus 1 birthday holiday
- Excellent 401(k) Retirement Saving Plan with employer match and contribution
- Robust employee recognition program
- Tuition reimbursement
- An opportunity to become part of a team that makes a difference to our members and our community every day!
