Practice Performance Advisor

The Performance Practice Advisor, is part of the POD support model and provides support to the Provider Network Management team and Provider Network responsible for producing and presenting performance reports, VBC models, care coordination effectiveness and practice efficiencies.

Collaborates with providers as it relates to HEDIS, withhold measures, TCOC performance metrics and other performance-based programs. Coordinates with the Quality Team on key reports and initiatives related to provider performance. Supports Account Executives and local market provider network team in directing interactions that relate to providers’ quality and performance. Responsible and accountable for improving provider’s performance.

Produce all quality and performance related reporting establishing opportunities and strategies regularly in preparation for JOC’s.

Interpret claims data and connections to patient outcomes and utilization trends.

Interprets utilization trends, optimizing performance based on state driven quality improvement programs i.e. HEDIS.

Attends meetings with providers to review gaps in care and developing plan of action with the provider to address these gaps in conjunction with PNM and CMO as applicable.

Supports network and quality strategy.

Implements and provides oversight of performance related projects as corporate best practices and strategy have identified.