Senior Manager Prof Provider Network Performance

Location: Remote within the continental United States, excluding California, New York, Alaska, and Hawaii; field-based with onsite provider office work typically 3 days per week and work from home 2 days per week. The role supports a territory covering Alabama, Southern Mississippi, and the Florida Panhandle. Candidates must live within 380 miles of the serviced territory and be willing to travel, including overnight stays.

Salary: $92,700–$167,500 annual base pay, with eligibility for an annual incentive bonus.

Company

hirify.global is a health insurance organization supporting Medicare Advantage operations and provider networks.

What you will do

• Manage relationships with assigned providers and negotiate provider agreements.
• Oversee the performance, growth, financial results, and value-based initiatives of an assigned provider network.
• Lead Provider Performance teams through staffing, training, coaching, and performance management.
• Partner with providers and internal stakeholders to improve quality, affordability, operational excellence, health outcomes, and member satisfaction.
• Support Stars and Risk Adjustment goals while ensuring compliance with CMS and company policies.
• Travel to provider offices and collaborate across the organization to strengthen provider relationships and support Medicare Advantage growth.

Requirements

• Bachelor’s degree in business or a related field plus four years of health care administration or managed care experience; eight years of similar experience may substitute.
• Strong verbal and written communication, analytical, planning, negotiation, and deadline-management skills.
• Ability to lead teams and build effective relationships in a cross-functional environment.
• Must live within 380 miles of the serviced territory and be willing to travel, including overnight stays.
• Sponsorship is not available.
• Ability to work typical Monday–Friday business hours, with occasional evening and weekend meetings.

Nice to have

• HEDIS and/or CMS STARs experience.
• Knowledge of health insurance, customer messaging and design, project management, and financial or trend analysis.
• Expert Excel skills, including pivot tables and VLOOKUP.
• Experience managing relationships and gaining buy-in in a matrix environment.
• Master’s degree, MBA, or equivalent advanced qualification.

Culture & Benefits

• Professional development plans and career growth support.
• Health and wellness benefits, 401(k) savings plan, pension plan, paid time off, and paid holidays.
• Paid parental leave, disability insurance, supplemental life insurance, and an employee assistance program.
• Tuition reimbursement and other incentive programs.