Health - Network Performance / Utilization Manager

About the role

Advise clients on network strategy, utilization performance, and provider market challenges across Medicaid, rural, and financially pressured environments. The successful candidate will combine deep domain expertise with strong consulting judgment and will be expected to manage teams, advise senior clients, and deliver complex engagements in network strategy, utilization and provider performance. This individual will build trusted client relationships and help clients improve network performance, access, and provider sustainability in line with their strategic priorities.

Responsibilities

• Advises clients on network strategy, provider capacity, utilization trends, access challenges, and market performance.
• Advises clients on evaluating leakage, referral patterns, service distribution, network adequacy, and provider sustainability.
• Develops strategic recommendations to improve network design, access, utilization management, provider alignment, and value-based outcomes.
• Translates claims, encounter, provider, and market data into clear insights, strategic options, and executive decision materials.
• Manages day-to-day engagement delivery, including workplans, team coordination, deliverable quality, and client communications.
• Works across reimbursement, analytics, policy, and provider strategy teams to solve complex market and performance challenges.
• Builds trusted relationships with client stakeholders and helps grow the practice’s network performance and utilization work.
• Travel: As required, up to 80%

Requirements

• Minimum of 5 years of experience in network strategy, utilization analytics, provider economics, or healthcare market analysis.
• Minimum of 2 years of experience assessing hospitals, rural providers, FQHCs, specialty providers, and community-based providers in Medicaid-heavy or financially distressed environments.
• Minimum of 2 years of experience turning claims, encounter, provider, and market data into strategic recommendations.

Qualifications

• Bachelor's Degree
• Familiarity with provider directory and network data management, data quality, and encounter completeness.
• Strong understanding of provider capacity, leakage, referral patterns, utilization drivers, access, and network adequacy.
• Ability to connect utilization performance to reimbursement, provider sustainability, and VBC outcomes.
• Experience building provider performance scorecards (utilization, quality, access, equity, financial impact).
• Understanding of service line strategy and site-of-care optimization (ASC vs HOPD, home-based care, telehealth).

Skills

• Strong analytical and problem-solving skills.
• Excellent communication and interpersonal skills.
• Proficiency in Microsoft Office Suite.
• Knowledge of healthcare regulations and compliance.

Benefits

• Market competitive suite of benefits including medical, dental, vision, life, and long-term disability coverage.
• 401(k) plan.
• Bonus opportunities.
• Paid holidays.
• Paid time off.

Pay

• Annual Salary Range: $94,400 to $293,800

Schedule

• Full-time