Regional Director - Northeast

About the Role

We are seeking a strategic, results-oriented Regional Director of Provider Engagement to own market-level performance across our Northeast region (CT, ME, MA, NH, NJ, NY, PA, RI, VT, DE, MD, DC). This is a senior leadership role with direct accountability for shared savings outcomes, quality improvement, utilization management, and provider adoption within Medicare Shared Savings Program (MSSP) and other value-based contracts.

The Regional Director leads a team of state-level Market Managers and Provider Consultants, translating organizational strategy into measurable, on-the-ground execution. The ideal candidate combines deep knowledge of value-based care models with strong people leadership and a data-driven mindset.

What You'll Do

Regional Strategy & Market Ownership

• Own overall Northeast market performance across MSSP and other assigned value-based contracts.
• Translate enterprise Provider Engagement strategy into Northeast-specific execution plans.
• Maintain current, working knowledge of provider groups across the region, including performance standings, active initiatives, and engagement risks.
• Serve as the primary escalation owner for Northeast market performance issues.

Financial, Quality & Utilization Performance

• Drive shared savings results year-over-year across MSSP and other contracts.
• Partner cross-functionally with Quality, Data, Population Health, and Operations teams to identify performance gaps and implement corrective actions.
• Monitor utilization and readmission trends and ensure timely interventions when performance is at risk.

Team Leadership & Supervision

• Directly supervise state Market Managers and Provider Consultant Supervisors across the region.
• Hold Market Managers accountable to KPI attainment (90%+ target) and foster a culture of continuous improvement.
• Coach, develop, and manage Provider Consultants; implement performance improvement plans as needed.
• Review touch reports and provider engagement documentation; provide actionable, documented feedback.

Provider Engagement & Compliance

• Ensure consistent execution of provider engagement standards, documentation requirements, and follow-up expectations.
• Maintain accuracy in provider data and ensure audit readiness across the team.
• Ensure timely escalations and document risks, interventions, and follow-up actions related to quality, utilization, and financial performance.
• Ensure compliance with organizational, contractual, and regulatory requirements.

What Success Looks Like

• Year-over-year increase in Northeast region shared savings for MSSP and other value-based contracts.
• Northeast region average quality score increases by at least 1% annually.
• Post-Discharge Visit (PDV) completion rates meet or exceed established regional targets.
• App usage "acted on" percentage remains above 80% for at least 75% of tracked weeks.
• Care management tool utilization increases a minimum of 1% per quarter across all contracts.
• Market Manager KPI achievement at or above 90%.
• 98%+ adherence to escalation policy timelines.
• At least 50% of touch reports reviewed with documented value-add feedback.

Qualifications

Required

• Bachelor's degree in Healthcare Administration, Business, Public Health, or a related field.
• 5+ years of experience in provider engagement, healthcare operations, ACOs, or value-based care.
• Demonstrated experience leading teams and driving performance through KPIs.
• Strong working knowledge of MSSP and value-based reimbursement models.
• Proficiency with MS Office (Word, Excel, Outlook, PowerPoint), Power BI, and data reporting tools.

Preferred

• Master's degree in a relevant field.
• Clinical background (RN, NP, PA, or MD).
• Experience working with FQHCs, IPAs, or multi-specialty groups.
• Familiarity with MSSP, Commercial, MIPS, and CMMI models.
• Knowledge of population health platforms and EHR systems.
• Experience with SQL, SSRS, and relational databases.

Key Competencies

• Market ownership and strategic execution
• Financial and quality performance management
• People leadership, coaching, and accountability
• Data-driven decision-making
• Provider relationship management
• Escalation and risk management
• High degree of professionalism, discretion, and confidentiality

Travel

Local travel is required. Overnight travel up to 1-2 times per month based on business needs.

Salary range may vary by location. Final compensation will be determined based on geographic market, experience, and qualifications.