Delegation Partnerships Performance Manager

Provider Delegation Performance Manager

The Provider Delegation Performance Manager is responsible for overseeing and improving the performance of CCAs delegated partnerships programs, working with clinical community partners responsible for care management and utilization management across CCAs One Care and SCO products. This role focuses on fostering strong clinical and programmatic collaboration, effectively communicating program performance to delegated providers, and supporting the implementation of CCAs model of care and strategic objectives. The Manager leads performance evaluation and improvement efforts, including reporting and data analysis, to ensure delegated entities meet contractual, regulatory, and quality standards that optimize member outcomes and operational efficiency. This versatile position offers exposure across multiple organizational areas and involves close collaboration with program leadership, operations teams, and external provider partners. The ideal candidate will have excellent organizational and analytical skills, with the ability to engage and coordinate with diverse internal and external stakeholders to identify opportunities and drive both program-wide and provider-specific performance improvement.

Essential Duties & Responsibilities :

• Performance Management :
• Assume full management responsibility for all performance measure components, including end-to-end data collection, evaluation, and timely dissemination of reports to both internal teams and delegated providers.
• Track and analyze site-level and program-wide KPIs to isolate gaps and identify key drivers of high and low performance.
• Generate monthly and quarterly performance and administrative reports, ensuring consistency, accuracy, and timely distribution to delegated providers.
• Develop a deep understanding of all program measures and metrics to support delegated providers in interpreting performance data and meeting expectations.
• Collaborate with providers individually to create and monitor performance improvement plans, engaging internal subject matter experts as needed and ensuring accountability for baseline performance standards.
• Coordinate cross-departmental efforts to raise awareness of knowledge gaps and clarify expectations around performance metrics.
• Maintain ownership of all guidance materials related to performance measures, ensuring they are accurate and up to date.
• Manage the development of formal Performance Improvement Plans and prepare presentation materials such as mid-year and annual reviews and program-wide performance summaries.
• Support delegated provider staff in using data tools effectively and understanding data interpretation.
• Oversee administrative components related to performance management activities as needed.
• Lead the programs contributions to performance measurement logic, reporting rules, exhibits, and reconciliation efforts in partnership with Business Intelligence, Finance, and Network teams.
• Understand CCAs operational and contractual requirements for delegated providers and implement performance monitoring and workflow adherence plans accordingly.
• Partner with Business Intelligence / Analytics teams to develop and present clinical, operational, and financial reports, proactively identifying opportunities for improvement.
• Coordinate technical assistance initiatives, including convening multidisciplinary teams and leveraging specialized CCA resources to support provider performance improvement strategies.
• Support broader organizational efforts to drive performance on HEDIS and STAR measures.
• Schedule and facilitate regular meetings, virtual or in person, with CBOs focused on provider education, program operations, regulatory requirements, performance and care team collaboration.
• Delegation Governance Committee Management :
• Support cross-functional delegation governance Steering Committee
• Manage schedule and agenda for ongoing meetings
• Disseminate meeting notes
• Manage all action items
• Coordinate with staff managing Member communications to ensure alignment between provider and member communications
• Develop routine internal reports of provider communications activities to keep both leadership and provider facing staff apprised of messaging and timelines.
• Present reporting and trends to the committee
• Develop and manage annual provider communications schedule
• Program Development and Operations Support :
• Assist with preparation and response activities related to formal CMS and state audits.
• Oversee special projects focused on program development, growth strategy, and new process design and implementation.
• Manage operational components of new program implementations, including project planning, stakeholder coordination, and deadline management.
• Collaborate across multiple internal teams and delegated providers to coordinate events, manage projects, and resolve daily operational issues.
• Support program leadership in developing and maintaining CCA Policies and procedures and trainings as they relate to delegation programs.
• Manages information, education and training to CCA staff, clinicians employed by CCA's clinical groups, contracted delegated entities and LTSS providers on delegation model.
• Maintain reporting inventory of all reporting shared with Delegation Providers as well as received internally to support the programs.
• Disseminate information to Delegation Partners
• Support Manager in developing guidelines, reference guides, workflows and SOPs, disseminating them to delegation entities and answering questions to ensure efficient day-to-day operations.
• Draft email communications under supervision of Manager.
• Support maintenance of materials and design of CCA Extranet / SharePoint as a key resource for information.
• Ongoing communication with Delegated Provider staff and CCA internal departments through email and phone calls.

Working Conditions :

This is a remote or hybrid role with the expectation of working according to Commonwealth Care Alliance's standard operating hours of 8 : 30am-5pm Monday-Friday.

Required Education (must have) : Bachelors degree

Desired Education (nice to have) : Masters degree in public health, business administration, health management, social work, or a related field preferred.

Required Experience (must have) :

Desired Experience (nice to have) :

Required Knowledge, Skills & Abilities :