Network Performance / Utilization Manager

Job title: Network Performance / Utilization Manager

About the Role 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. Build trusted client relationships and help clients improve network performance, access, and provider sustainability in line with their strategic priorities.

What You'll Do

• 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.

What We're Looking For

• 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 if you have: Familiarity with provider directory and network data management, data quality, and encounter completeness.
• Bonus points if you have: Strong understanding of provider capacity, leakage, referral patterns, utilization drivers, access, and network adequacy.
• Bonus points if you have: Ability to connect utilization performance to reimbursement, provider sustainability, and VBC outcomes.
• Bonus points if you have: Experience building provider performance scorecards (utilization, quality, access, equity, financial impact).
• Bonus points if you have: Understanding of service line strategy and site-of-care optimization (ASC vs HOPD, home-based care, telehealth).