• Develop strategic partnerships between the health plan and the contracted provider networks serving our communities • Engage with providers to align on network performance opportunities and solutions, and consultative account management and accountability for issue resolution • Drive optimal performance in contract incentive performance, quality, and cost utilization • Participate in the development of network management strategies • Assist in the strategic implementation of new initiatives for performance improvement • Serve as primary contact for providers and act as a liaison between the providers and the health plan ensuring a coordinated effort in improving financial and quality performance • Identify and deliver solutions to providers concerns and issues as needed for resolution to internal partners • Receive and effectively respond to external provider related issues • Investigate, resolve and communicate provider claim issues and changes • Engage with and educate providers regarding policies and procedures related to referrals and claims submission, web site usage, EDI solicitation and related topics • Perform provider orientations and ongoing provider education, including writing and updating orientation materials • Manage Network performance for assigned territory through a consultative/account management approach • Evaluate provider performance and develop strategic plan to improve performance • Drive provider performance improvement in the areas of Risk/P4Q, Health Benefit Ratio (HBR), HEDIS/quality, cost and utilization • Present detailed HBR analysis and create reports for Joint Operating Committee meetings (JOC) • Develop proficiency in tools and value-based performance (VBP) and educate providers on use of tools and interpretation of data • Coach new and less experienced External Reps