Palm Beach Accountable Care Organization

Job Description 

Job Title: Regional Director –Northeast

Department: Provider Engagement (PC)

Reports To: Chief Performance Officer

FLSA Status: Exempt

Prepared By: Human Resources Department

Prepared Date: 12/2025

DISCLAIMER:

Job descriptions are not meant to be all-inclusive and/or the job itself is subject to change. Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time.

Summary: 

The Regional Director – Northeast is accountable for translating organizational and Provider Engagement strategy into measurable, market-level execution across the Northeast region (current states include CT, ME, MA, NH, NJ, NY, PA, RI, VT, DE, MD, DC). This role owns Northeast market performance outcomes for MSSP and contributes heavily to other value-based contracts (e.g., Commercial), with primary accountability for shared savings, quality improvement, utilization management, and provider adoption metrics.

The Regional Director provides direct leadership and supervision to state Market Managers and designated Provider Consultants, ensuring KPI attainment, operational rigor, and consistent execution of engagement standards. This role serves as the market owner for the Northeast, responsible for performance trends, escalation management, and alignment between providers, consultants, and internal teams.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Regional Strategy and Market Ownership

• Own overall Northeast market performance for MSSP and other assigned value-based contracts.

• Translate Provider Engagement and organizational strategy into Northeast-specific execution plans.

• Maintain a working, current knowledge of Northeast provider groups, including performance standings, active initiatives, and engagement risks and opportunities.

• Serve as the primary escalation and decision-making owner for Northeast market performance issues.

Financial, Quality, and Utilization Performance
 • Drive shared savings results across MSSP and other contracts, with accountability for year-over-year improvement.
 • Partner 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.

Leadership and Supervisory Responsibilities
 • Directly supervise the state Market Managers (if the state has one) or highest-level Provider Consultant Supervisor in each state/area. 
 • Ensure the Market Manager(s) achieves at least 90% of assigned KPIs.
 • Directly supervise Provider Consultants who report to this role and are not managed under a Market Manager or Regional Manager. 
 • Hold Provider Consultants accountable to all KPIs outlined in the Provider Consultant job description.
 • Implement coaching plans, performance improvement plans, and corrective actions as needed.
 • Foster a culture of accountability, data-driven decision-making, and continuous improvement.

Provider Consultant Oversight and Enablement
 • Review and provide actionable feedback on touch reports and dailies.
• Must read and add documented value to at least 50% of submitted reports of whole Provider Consultant team; 75% for Market Manager(s).
 • Use insights from reports to shape provider engagement strategy and consultant focus.
 • Ensure consistent execution of engagement standards, documentation requirements, and follow-up expectations.
 • Ensure Provider Consultants maintain PDV accuracy, audit readiness, and adoption of required tools.

Provider Engagement and Direct Coverage
 • For any provider offices personally served by the Regional Director, all Provider Consultant expectations, KPIs, and metrics apply in full.
 • Must meet or exceed engagement cadence, documentation, PDV, and adoption standards.

Escalation Management and Compliance

• Ensure timely escalations in accordance with the established escalation policy.

• Document risks, interventions, and follow-up actions related to quality, utilization, financial, or engagement concerns.

• Ensure compliance with organizational, contractual, and regulatory requirements.

KEY PERFORMANCE INDICATORS (KPIs)

Financial and Contract Performance
 • Northeast Region market-level shared savings must increase year-over-year (YOY) for MSSP.
 • Other value-based contracts (including PHP and Commercial) must meet or exceed contract-specific financial and operational KPIs.

Quality Performance
 • Northeast Region average quality score must increase by at least 1% YOY.

Post Discharge Visit % (PDV)
 • Northeast Region PDV completion rate must reach at least 60% increase annually each year after that.

• If Northeast Region MSSP readmission rates exceed the national average, the Regional Director must demonstrate documented intervention efforts and at least 90% PDV audit compliance across all Florida Provider Consultants.

Provider and Tool Adoption
 • App usage acted on percentage must remain above 80% for at least 75% of the weeks of the year, tracked quarterly.
• Caretracker utilization in Northeast Region must increase by a minimum of 1% per quarter (across all contracts).

Utilization and Readmissions
 • Florida MSSP readmission rates must not exceed the national average.
 • If exceeded, documented remediation plans and audit compliance are required.

Leadership and Execution
 • Market Manager(s) KPI achievement must be at least 90%.
 • Provider Consultants must meet all KPIs defined in their job descriptions.
 • At least 50% of touch reports and dailies must be reviewed with documented value-add.
 • 98% adherence to escalation policy timelines is required.

TRAVEL REQUIREMENTS

• Local travel is required.
 • Overnight travel is required up to 1–2 times per month, as business needs dictate.

Supervisory Responsibilities:

Yes. Market Manager(s) or highest level Provider Consultant Supervisor and all Provider Consultants without a State/are a PC Manager. All Northeast Region MSSP Provider Consultants are downstream.

Qualifications

Education & Experience
 • Bachelor’s degree in Healthcare Administration, Business, Public Health, or related field required; Master’s degree preferred.
 • 5 or more 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.

Skills & Competencies

COMPETENCIES

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

Preferred Qualifications

• Clinical background (e.g., RN, NP, PA, MD) a plus


• 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

Language Skills:

Ability to read and comprehend simple instructions, correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one situations to visitors, clients, physicians, healthcare entities, leadership and other employees of the organization.

Reasoning Ability: 

Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions.

Computer Skills: 

MS Office Productivity Tools (Word, Excel, Outlook, PowerPoint), SQL, Power BI, SSRS, relational databases and other related software/technology.

Other Skills and Abilities: 

High accuracy and extreme confidentiality a MUST. Detailed oriented and very organized.

Physical Demands:

While performing the duties of this Job, the employee will have a combination of standing, sitting, bending and reaching. May work at a computer monitor for prolonged periods. The employee may lift and/or move up to 10 pounds.

____________________________ ______________________________ _________

Employee Signature Employee Print Name Date