Specialist, Performance Improvement

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Job Summary

The Provider Success Specialist I is primarily responsible for helping assigned medical providers and their staff drive positive financial performance, appropriate utilization, and high quality to meet and exceed performance targets for all assigned value-based programs across any number of lines of business. They accomplish this by providing expert population health management data and analysis, facilitating best practices, and setting/tracking goals by acting as a primary accountable change agent for assigned providers and business lines. In addition, the Performance Improvement Specialist coordinates support activities with various departments to provide optimal customer service to network providers and internal customers. Lines of assigned businesses may include MSSP Accountable Care Organizations (ACO), Direct Contracting Entities, Commercial ACOs, Medicare Advantage, and others.

Essential Duties & Responsibilities

• Assists in managing providers in multiple markets, lines of business, and provider networks.
• Understands and educates clients on any assigned business lines related to value-based contracts.
• Analyzes financial and quality reports to identify opportunities that will be presented to physicians and staff.
• Monitors and manages progress of key performance indicators given to providers to ensure all goals are met.
• Documents and provides feedback to leadership team regarding provider meetings.
• Creates provider performance reports as well as presentations.
• Maintains provider in-service log, all tracking tools and provider portal.
• Assists in creating provider manuals as well as monthly and quarterly provider reports.
• Creates practice assessments and other engagement tracking functions.
• Identifies and provides solutions and interventions for providers whose key metrics are underperforming.
• Handles office tasks, such as scheduling conference calls and meetings
• Makes travel arrangements, such as booking flights, cars, and makes hotel and restaurant reservations.
• Maintains polite and professional communication via phone, e-mail, and mail.
• Engages providers and educates them on performance improvement initiatives.
• Provides Management with feedback from providers with issues and concerns.
• Works closely with Provider Network team and other departments to main open line of communication
• All other duties as assigned.

Supervisory Responsibilities

• No supervisory responsibilities required.

Critical Results

Meets with assigned providers consistently according to established schedules > 90%
Provides timely documentation on all assignment related activities according to established requirements >90%
Produces an aggregated positive quarter over quarter financial performance for assigned practices > 90%

Best Practices

Manages time in an orderly and consistent manner.
Produces task plans for accomplishing all significant work assignments.
Uses company provided productivity tools actively.

Education & Experience

• Bachelor’s degree in Business, Healthcare or related field.
• Possess 5+ years’ experience in healthcare or sales field.

Education Requirements

Education Level

Discipline

Required

Bachelor' Degree

Business, Healthcare or related field.

Knowledge, Skills & Proficiencies

• Strong written and communication skills
• Strong initiative skills
• Strong analytical and data management skills
• Must be detail-oriented, possess exceptional communication and interpersonal skills, organization skills and a spirit with a willingness to go above and beyond the call of duty in order to complete projects accurately and timely.
• Must also be able to multi-task, work in a fast-paced environment and abide to specific deadlines.

Physical Requirements

This position works under usual office conditions. The associate is required to work at a personal computer as well as be on the phone for extended periods of time. Must be able to stand, sit, walk and occasionally climb. The incumbent must be able to work extended and flexible hours and weekends as needed. Physical demands include ability to lift up to 50 lbs. The physical demands described here are representative of those that must be met by an associate to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Work Conditions

Must be able to perform essential functions such as typing, standing, sitting, stooping, and occasionally climbing. 

Travel Requirements

Amount of Expected Travel

Details

Yes

0-25%

Flexibility to travel to clinical sites as needed

Tools & Equipment Used

Computer and peripherals, standard and customized software applications and tools, and usual office equipment.

Disclaimer

The duties and responsibilities described above are designed to indicate the general nature and level of work performed by associates within this classification. It is not designed to contain, or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of associates assigned to this job. This is not an all-inclusive job description; therefore, management has the right to assign or reassign schedules, duties, and responsibilities to this job at any time. Cano Health is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.

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