Vice President, Provider Performance Programs - (Baton Rouge, LA)

ProfessionalPosition Purpose: Lead provider management efforts and support health plan network management through the development and application of performance initiatives related to key provider indicators, including quality, cost effectiveness, clinical and service delivery effectiveness , and fraud, waste and abuse (FWA) activities Provide strategic direction and planning to health plan provider management efforts related to provider performance Develop cross functional operational systems to accumulate and analyze data and intangible analytics to identify opportunities for provider performance management Oversee the evaluation of provider utilization, cost, and quality trends and recommend solutions for improvement Drive development of initiatives based on identified opportunities utilizing industry-standard analytic, quality or clinical criteria Demonstrate and report on effectiveness of initiatives, including ROI