Manager, Provider Operations

Company Overview:

Upward Health is an in-home, multidisciplinary medical group providing 24/7 whole-person care. Our clinical team treats physical, behavioral, and social health needs when and where a patient needs help. Everyone on our team from our doctors, nurses, and Care Specialists to our HR, Technology, and Business Services staff are driven by a desire to improve the lives of our patients. We are able to treat a wide range of needs everything from addressing poorly controlled blood sugar to combatting anxiety to accessing medically tailored meals because we know that health requires care for the whole person. Its no wonder 98% of patients report being fully satisfied with Upward Health!

Job Title & Role Description:

The Manager, Provider Operations is an operational leader responsible for driving high-performance outcomes across Upward Healths national provider network. This role oversees Nurse Practitioners, Licensed Clinical Social Workers, Behavioral Health providers, and other clinical professionals, ensuring strong clinical execution, consistent productivity, and measurable quality results across all programs.

This leader is accountable for achieving targeted completed provider visits, closing quality gaps, and supporting HEDIS-aligned performance. The role requires ownership of provider initiatives, proactive leadership of projects, and strong engagement with internal and external stakeholders. The Manager thrives in a fast-paced, rapidly growing environment and adapts quickly as expectations, workflows, and client needs evolve.

This position requires up to 10% travel across the country to support market growth, provider onboarding, training, performance reviews, operational launches, and quality improvement efforts.

Core Responsibilities :

• Lead all aspects of provider operations across assigned regions to achieve productivity, quality, and compliance targets.
• Ensure provider performance meets or exceeds organizational expectations for completed visits, timeliness, documentation quality, and patient experience.
• Drive execution of quality-focused initiatives that support HEDIS, closing of care gaps, and behavioral and physical health outcome measures.
• Maintain full accountability for operational metrics including panel assignments, provider capacity, completed visits, and quality adherence.
• Proactively identify performance issues, prioritize root-cause solutions, and implement scalable improvements without waiting for direction.
• Lead national and cross-functional initiatives that improve provider workflows, training, telehealth integration, and patient outcomes.
• Anticipate operational needs in fast-changing environments; adjust workflows and team expectations quickly while maintaining performance stability.
• Provide strategic guidance to providers and partner leaders on care delivery models, telehealth best practices, and operational execution.
• Partner with leadership to design and refine processes that support rapid scaling and efficient care delivery across multiple markets.
• Conduct field and virtual provider coaching, performance reviews, targeted interventions, and development plans to ensure consistent growth and standardized expectations.
• Support clinical launches, program redesigns, and client-specific performance initiatives across the organization.

Skills Required:

• Bachelors degree required. Masters degree preferred.
• Five or more years of experience in provider operations, clinical operations, or healthcare management.
• Minimum three years in a leadership role supporting clinical teams.
• Demonstrated success improving provider productivity and quality outcomes in a high-growth environment.
• Experience with HEDIS, quality gap closure, and Medicare/Medicaid quality programs.
• Skilled in managing detailed performance metrics and using data to drive operational decisions.
• Proven ability to lead projects, build structure, and take ownership of new initiatives without reliance on others for direction.
• Strong working knowledge of telehealth operations, clinical workflows, and interdisciplinary care models.
• Ability to execute effectively in a complex, rapidly changing environment with shifting priorities

Key Behaviors & Competencies:

Leadership and Motivation

• Leads provider teams with clarity and confidence. Sets expectations, drives accountability, and maintains strong engagement. Supports providers through coaching, structured communication, and consistent follow up.

Strategic Thinking

• Plans ahead using data and operational trends. Designs strategies that improve provider productivity, quality outcomes, and care delivery efficiency while aligning with organizational goals.

Operational Agility

• Performs effectively in rapid growth environments. Adapts quickly as workflows, priorities, and client needs change. Maintains steady performance during periods of transition.

Data Driven Problem Solving

• Uses data daily to identify barriers, evaluate performance, and guide operational decisions. Builds targeted action plans that lead to measurable improvements in provider productivity, HEDIS performance, and quality gap closure.

Outcome Oriented

• Keeps a strong focus on completing provider visits and closing quality gaps. Ensures that operational decisions support productivity, compliance, and patient outcomes.

Collaboration

• Works closely with Clinical Operations, Quality, Recruiting, Learning and Development, Medical Directors, and market leadership to ensure aligned and efficient care delivery.

Provider Performance Optimization

• Monitors productivity, visit completion, documentation, and quality measures. Identifies issues quickly and leads interventions that improve results across assigned markets.

Initiative and Ownership

• Takes action without waiting for direction. Identifies what needs to happen, leads execution, and follows through until work is complete. Holds self and providers accountable for results.

Telehealth Expertise and Integration

• Strengthens telehealth workflows and improves provider efficiency. Ensures processes support timely visits, documentation accuracy, and patient engagement.

Compliance and Regulatory Adherence

• Maintains knowledge of Medicaid, Medicare, and behavioral health requirements. Ensures provider practices are compliant and aligned with internal and external standards.

Team Development and Mentorship

• Supports provider growth through feedback, development plans, and structured coaching. Helps onboard new providers and reinforces expectations consistently.

Cultural Competency

• Engages effectively with diverse populations and adapts communication to meet patient and provider needs.

Upward Health is proud to be an equal opportunity employer. We are committed to attracting, retaining, and maximizing the performance of a diverse and inclusive workforce. This job description is a general outline of duties performed and is not to be misconstrued as encompassing all duties performed within the position.

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