Health - Network Performance / Utilization Manager
$94.4k - $293.8kAccenture
Role Summary 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 Advise clients on network strategy, provider capacity, utilization trends, access challenges, and market performance. Advise clients on evaluating leakage, referral patterns, service distribution, network adequacy, and provider sustainability. Develop strategic recommendations to improve network design, access, utilization management, provider alignment, and value‑based outcomes. Translate claims, encounter, provider, and market data into clear insights, strategic options, and executive decision materials. Manage day‑to‑day engagement delivery, including workplans, team coordination, deliverable quality, and client communications. Work across reimbursement, analytics, policy, and provider strategy teams to solve complex market and performance challenges. Build trusted relationships with client stakeholders and help grow the practice’s network performance and utilization work. Travel: Up to 80% as required. Qualifications 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. Bachelor’s Degree. Bonus points for 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). Compensation and Benefits Compensation ranges by location: California: $94,400 to $293,800 Cleveland: $87,400 to $235,000 Colorado: $94,400 to $253,800 District of Columbia: $100,500 to $270,300 Illinois: $87,400 to $253,800 Maryland: $94,400 to $253,800 Massachusetts: $94,400 to $270,300 Minnesota: $94,400 to $253,800 New York: $87,400 to $293,800 New Jersey: $100,500 to $293,800 Washington: $100,500 to $270,300 Accenture offers a market‑competitive suite of benefits including medical, dental, vision, life, and long‑term disability coverage, a 401(k) plan, bonus opportunities, paid holidays, and paid time off. Equal Employment Opportunity Statement We believe that no one should be discriminated against because of their differences. All employment decisions shall be made without regard to age, race, creed, color, religion, sex, national origin, ancestry, disability status, veteran status, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status or any other basis as protected by federal, state, or local law. Our rich diversity makes us more innovative, more competitive, and more creative, which helps us better serve our clients and our communities. Accenture is an EEO and affirmative action employer of veterans/individuals with disabilities. Accenture is committed to providing veteran employment opportunities to our service men and women. #J-18808-Ljbffr Accenture
- A global management consulting firm seeks an experienced consultant to advise clients on network strategy and utilization performance in challenging environments. The successful candidate will leverage extensive experience in healthcare analytics and provider economics...Network
- ...communities. The Center utilizes a universal, evidence... ...of Entry Utilization Management Nurse (POE) has strong... ...to all members of the health care team on defensible... ...Responsibilities Performs chart review of assigned... .... -.5% Verifies in-network verses out-of-network...NetworkWork at office
$270k - $340k
...Future Evolves Here Evolent partners with health plans and providers to achieve better... ...for individuals facing cancer. As a Performance Suite Medical Director in Medical... ...throughput, this position integrates utilization management with collaborative engagement and innovation...SuggestedImmediate start- Cardinal Health is looking for a Performance and Transformation Manager based in Hartford, Connecticut. This strategic role is essential in bridging the relationship between business process owners and the Learning & Development Center of Excellence. Responsibilities include...Suggested
$94.4k - $293.8k
...healthcare providers to achieve both operational excellence and clinical outcomes. Position Overview As a Clinical & Financial Performance Manager you will lead initiatives that align clinical performance with financial outcomes, improving total cost of care, quality...SuggestedLive inWork at officeLocal areaWorldwide$105.1k - $150.1k
What Program and Project Management contributes to Cardinal Health Transformation enables the organization to drive complex and transformational programs... ...and deliverables into project plans. Job Summary The Performance and Transformation Manager is a key strategic role...Temporary workWork experience placementLocal areaFlexible hours- ...of the Yale New Haven Health System (YNHHS) healthcare... ...as demonstrated by utilizing the nursing process components... ...OF PROFESSIONAL PERFORMANCE The ANA Standards... ...CNO) in each delivery network, and RNs are accountable... ...and interventional management of coronary artery disease...Network
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Aetna, a CVS Health Company, is looking for a Medical Director (Ortho/Total... ...expertise and lead medical management programs. This role is remote based... ...medical management programs, direct utilization reviews, and collaborate with network providers. Required...NetworkRemote jobFlexible hours- ...Avon, CT seeks a Medical Laboratory Scientist to perform and interpret clinical laboratory tests, utilizing advanced problem-solving skills. The ideal candidate... ...growth opportunities within Connecticut's leading healthcare network. #J-18808-Ljbffr Hartford HealthCareNetwork
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...part of Connecticut’s most comprehensive healthcare network as a Registered Nurse. POSITION SUMMARY: Utilizing the nursing process, provides high quality direct... ...and interactions. Reports to the Clinical Nurse Manager. Qualifications EDUCATION/CERTIFICATION:...NetworkHourly payPermanent employment- ...Connecticut's most comprehensive healthcare network. Hartford HealthCare Medical Group... ...responses to actual or potential health problems utilizing appropriate practices, standards, protocols... .... This position reports to a Practice Manager. Provides office-based nursing care...NetworkWork at officeShift work
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...most comprehensive healthcare network as a Registered Nurse. POSITION SUMMARY: Utilizing the nursing process, provides high... ...Reports to the Clinical Nurse Manager. Qualifications EDUCATION... ...your moment . Why Vivian Health? Be sure to apply via Vivian...NetworkHourly payPermanent employment
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