Payer Program Performance Specialist

JOB SUMMARY

This position is responsible for managing performance outcomes for a subset of healthcare clients. The role serves as a subject matter expert on the performance and financial aspects of assigned client contracts. Responsibilities include analyzing performance against client expectations and financial targets, identifying performance gaps, and implementing strategies to drive improved results. This individual may also support and lead performance initiatives that span across the department.

KNOWLEDGE & REQUIREMENTS

What is expected of you and others at this level:

Applies working knowledge of concepts, principles, and technical capabilities to perform varied tasks

Works on projects of moderate scope and complexity

Identifies possible solutions to a variety of technical problems and takes action to resolve them

Applies judgment within defined parameters

Receives general guidance and may receive more detailed instruction on new projects

Work is reviewed for sound reasoning and accuracy

EDUCATION & EXPERIENCE REQUIREMENTS

Minimum of 2 years of experience in a healthcare-related field

Bachelor’s degree required

ESSENTIAL DUTIES & RESPONSIBILITIES

Analyze and understand performance against client contracts, including KPIs and financial targets

Identify performance barriers and develop action plans to meet performance goals

Collaborate cross-functionally to execute performance improvement initiatives

Serve as a subject matter expert on performance drivers and barriers for assigned clients

Partner with account management teams to support client discussions and strategy

Coordinate with finance to communicate expected performance outcomes

Support contract negotiations by providing performance insights and feasibility assessments