Description
The Practice Transformation Manager (Value-Based Care) serves as a high-impact individual contributor responsible for advancing value-based care performance across the Accountable Care Organization (ACO) and affiliated Independent Practice Association (IPA) within the San Jose/Santa Clara County market.
Reporting directly to the Vice President, Strategy and Partnerships, this role serves as a strategic advisor and primary liaison to providers, practice leaders, and internal stakeholders. The position exercises substantial independent judgment and discretion in evaluating provider and market performance, identifying opportunities for operational and clinical improvement, developing provider engagement strategies, and recommending solutions that impact quality, utilization, risk adjustment, provider satisfaction, regulatory compliance, and financial performance.
The Manager independently leads complex initiatives, influences provider and organizational decision-making, and partners with regional and national value-based care teams to drive sustainable performance improvement and successful execution of organizational priorities.
What You'll Do
Provider Engagement & Performance Improvement
- Serve as the primary strategic liaison for ACO and IPA providers, fostering strong relationships that drive engagement, satisfaction, compliance, and performance.
- Independently assess provider, practice, and market performance to identify improvement opportunities and develop strategies aligned with value-based care.
- Conduct in-person and virtual meetings with physicians, provider groups, practice administrators, and clinical staff to present performance data, communicate priorities, and influence operational and clinical improvements.
- Develop and implement provider engagement, onboarding, education, and adoption strategies for value-based care initiatives and new technologies.
- Build and maintain trusted relationships with key provider stakeholders to advance long-term IPA and ACO objectives.
- Monitor provider performance using quality, utilization, referral management, risk adjustment, operational, and financial metrics.
- Partner with coding, clinical, and operational teams to support HCC documentation and risk adjustment initiatives.
- Lead provider change management and practice transformation by evaluating workflows, identifying performance barriers, and recommending solutions that improve operations and patient outcomes.
- Analyse practice operations and recommend improvements to Annual Wellness Visit workflows, scheduling, quality programme execution, referral management, and other value-based care initiatives.
- Evaluate performance improvement initiatives and adjust strategies based on outcomes, market conditions, and organisational priorities.
Strategic Leadership & Cross-Functional Collaboration
- Independently manage complex projects and initiatives involving multiple departments, provider organisations, and external stakeholders.
- Use independent judgement to prioritise projects, evaluate alternatives, resolve operational challenges, and recommend solutions that significantly impact provider and organisational performance.
- Serve as a liaison among Value-Based Care, Operations, Business Development, Quality, Coding, Finance, and other internal teams to ensure alignment and successful execution of strategic initiatives.
- Provide data-driven analysis, recommendations, and presentations to leadership on provider performance, operational effectiveness, and market opportunities.
- Collaborate with regional and national ACO leadership to support organisational priorities and market performance objectives.
- Identify, develop, and share best practices across provider networks and markets to improve organisational effectiveness and value-based care outcomes.
- Serve as a subject matter expert on provider engagement, practice transformation, value-based care operations, and Market Representative activities that support ACO performance.
- Partner with leadership to align performance improvement initiatives with broader ACO and organisational objectives.
- Other duties as assigned.
Qualifications
Education:
- Bachelor’s degree in Healthcare Administration, Business, Finance, or related field required
Experience:
- At least 5 years of experience in provider network relations, contracting, provider data management healthcare operations, managed care, or related field
- Experience in provider relations, IPA, and ACO experience preferred
- Demonstrated experience analyzing data and making recommendations that impact business or operational outcomes
Knowledge, Skills, and Abilities:
- Demonstrated ability to exercise independent judgment and discretion in evaluating provider and market performance and recommending solutions on matters of significance.
- Strong analytical, problem-solving, and decision-making skills.
- Ability to interpret complex healthcare data and translate findings into actionable business strategies.
- Advanced understanding of value-based care, population health management, managed care, IPA operations, and provider performance improvement.
- Working knowledge of CMS, DMHC, DHCS, Medicare, ACO, and applicable regulatory requirements.
- Ability to influence stakeholders and drive change through collaboration and relationship management.
- Strong business acumen and ability to evaluate operational and financial implications of recommendations.
- Excellent communication, facilitation, presentation, and consultative skills.
- Ability to independently manage competing priorities in a fast-paced environment.
- Advanced proficiency with Microsoft Office applications and healthcare reporting and analytics tools.
Environmental Job Requirements and Working Conditions
- This is a hybrid position requiring work in both an office environment and provider offices throughout the San Jose / Santa Clara County Market. Regular local travel is required to support provider onboarding, operational coordination, and market activities. The role involves prolonged computer use, frequent interaction with internal stakeholders and provider offices, and occasional attendance at meetings or company events as business needs require.
- The national target pay range for this role is $102,000 - $111,000 per year. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at
humanresourcesdept@astranahealth.com
to request an accommodation.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.