Work Location: NY/NJ
Work Setting: Hybrid
About NSIPA:
Network Solutions IPA (NSIPA) is a leading New York–based Independent Practice Association with a diverse, multi-specialty provider network. The organization has grown to more than 600 physician members, serving over 100,000 patients across New York City, Nassau, Suffolk, and Westchester counties.
We are committed to helping independent providers succeed in the transition to value-based care.
Through strategic partnerships, operational support, and robust payer relationships, NSIPA delivers the tools, resources, and expertise that allow practices to grow, perform, and succeed in today’s complex healthcare landscape without sacrificing independence. We achieve this by collaborating with payers to deliver Quality Incentive Programs, Shared Savings arrangements, and Risk-Based Contracts. Contracted with over 21+ Payers for over 600+ Providers.
NSIPA provides a comprehensive suite of services, including credentialing and network operations, provider engagement, and contracting; care coordination and member outreach; and provider-and patient centered programs. As part of New York State’s 1115 Medicaid Waiver, NSIPA plays a key role in identifying, screening, and addressing health-related social needs by connecting Medicaid members to community-based resources and care supports. These services are designed to strengthen provider efficiency, address health related social care needs, and advance value‑based care and population health opportunities. Recognized as one of New York’s fastest‑growing IPAs, NSIPA supports improved clinical outcomes, enhanced provider performance, and cost savings for payers through its robust infrastructure and operational expertise.
Position Overview:
We are seeking an experienced leader to oversee NSIPA’s value-based care strategy and quality performance across all payer contracts. This role is responsible for improving clinical quality, utilization, and financial outcomes while driving population health initiatives and ensuring strong performance under value-based and risk-based arrangements.
The Director will lead the Population Health Quality team and collaborate with executive leadership, providers, payers, and cross‑functional teams to drive measurable improvements in cost, quality, and care delivery. This is an ideal opportunity for a seasoned leader who thrives in complex, multi‑payer environments and is passionate about improving care for Medicare, Medicaid, and managed care populations.
Roles & Responsibilities:
· Own NSIPA’s value-based care and quality improvement strategy across all payer programs.
· Oversee performance related to MER, total cost of care, utilization, and quality outcomes.
· Partner with executive leadership and cross-functional teams to identify performance risks, opportunities, and intervention strategies.
· Lead quality programs including HEDIS, QARR, CAHPS measures, medication adherence and transitions of care.
· Develop and execute performance improvements and corrective action plans.
· Oversee performance monitoring and improvement initiatives related to quality, utilization, and total cost of care metrics.
· Collaborate with Provider Engagement to support underperforming providers and ensure documentation and quality standards are met.
· Partner with Data & Analytics to turn complex claims, EHR, and payer data into actionable insights.
· Build and guide a high-performing Population Health Quality team.
· Provide oversight of the Peer Review Committee (PRC), including case review, provider communication, documentation, and reporting.
· Serve as a key liaison with payer partners on VBC performance, quality initiatives, and contractual requirements.
· Ensure compliance with regulatory, audit, and accreditation standards.
· Support performance strategies under risk-based, shared savings, and value-based arrangements.
· Responsible for developing educational materials and resources, including content, brochures, and one-pagers, centered on quality and value-based care (VBC) initiatives to support provider and staff education and performance improvement efforts.
Skills & Competencies:
· Strong understanding of value-based care, population health, and risk arrangements.
· Expertise in quality measurement (HEDIS, QARR, CAHPS, CMS).
· Advanced analytical skills with the ability to interpret and act on complex data.
· Strong leadership, communication, and cross-functional collaboration skills.
· Ability to manage multiple priorities in a fast-paced environment.
· Proficiency in MS Office, experience with data visualization tools (Tableau) or similar tools preferred.
Required Qualifications:
· Bachelor's degree in a health-related field
· Clinical background (RN preferred) or relevant quality credential
· 5+ years of experience in value-based care, quality improvement, or population health.
· 3+ years of experience in a health plan, IPA, MSO, or integrated delivery system.
· Experience managing performance across multiple-payer contracts.
· Prior leadership and people management experience.
Why Join NSIPA?
· High-impact leadership role with direct influence on organizational strategy.
· Opportunity to shape the future of value-based care across diverse populations.
· Collaborative, mission-driven environment focused on improving patient outcomes.
· Visibility, growth, and the ability to build and scale performance programs.
Physical Demands:
The physical demands described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable qualified individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to stand; walk; sit for extended periods of time; use hands to finger, handle, or feel; make precisely coordinated movements of the fingers of one or both hands to grasp, manipulate, or utilize computer equipment; reach with hands and arms; and talk or hear. The employee must occasionally lift and/or move up to 20 pounds. Specific vision abilities required by this job include close vision, distance vision, ability to adjust focus and ability to match or detect differences between colors, including shades of color and brightness.
EEO Statement:
NSIPA is an equal opportunity employer committed to diversity and inclusion. We encourage applications from all qualified individuals regardless of race, color, religion, gender, sexual orientation, age, national origin, disability, or veteran status.