Provider Performance Specialist II (Managed Healthcare)

Location: Field based in the New York City area, New York; U.S. work authorization required

Salary: $56,200–$101,000 per year

Company

hirify.global provides healthcare services and supports access to care for individuals, families, and communities.

What you will do

• Provide consultative support to healthcare providers on member outreach, utilization management, cost, quality, and risk performance.
• Analyze performance reporting, member engagement data, and other resources to identify opportunities to improve member outcomes.
• Prepare insights and presentation materials covering year-to-date results, month-over-month performance, and member engagement.
• Facilitate provider discussions on quality, utilization, cost, and risk improvement opportunities using corporate tools and reporting.
• Coordinate communication and goals with health plan quality counterparts.
• Develop provider education on value-based performance tools and present Health Benefits Ratio analysis for Joint Operating Committee meetings.

Requirements

• Bachelor’s degree in a related field or equivalent experience.
• At least 2 years of combined managed healthcare and provider reimbursement experience.
• Experience with claims processing or managed care is preferred.
• Must be authorized to work in the U.S. without current or future employment-based visa sponsorship.
• For Fidelis Care NY positions, a valid state clinical license such as LPN or RN is preferred.

Culture & Benefits

• Health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off, and holidays.
• Flexible work approaches may include remote, hybrid, field, or office schedules; this position is field based in the New York City area.
• Pay is adjusted based on skills, experience, education, and other job-related factors.
• Additional incentive compensation may be available, subject to eligibility.