Director of Provider Engagement & Value-Based Care

Astrana Health Management; Houston (TX); Hybrid; USD 85,000 - 130,000; Full time

Job summary

Astrana Health Management is seeking a Director, Provider Relations to lead a dynamic team and drive engagement, performance improvement, and value-based care strategies across markets. This senior role partners with cross-functional teams to improve quality, risk adjustment, and financial outcomes.

The position requires deep expertise in provider operations, managed care, and population health, with a focus on collaboration, strategic advisory, and market expansion. Travel may be required.

Qualifications

• Bachelor's degree in Healthcare Administration, Business Administration, Nursing, Public Health, Finance, or a related field.
• 8+ years of healthcare leadership experience in Provider Relations, Managed Care, Value-Based Care, Population Health, IPA Operations, ACO Operations, or Network Performance.
• 5+ years of progressive leadership experience managing provider-facing teams.
• Demonstrated success leading provider performance improvement initiatives.
• Experience working with Medicare Advantage, Medicaid, Commercial, and Value-Based Care programs.
• Experience managing complex provider networks, delegated arrangements, and strategic provider partnerships.
• Strong understanding of physician practice operations, managed care, and value-based care delivery models.
• Expertise in practice transformation, provider engagement, population health management, and performance improvement strategies.
• Strong knowledge of HEDIS, CMS Star Ratings, risk adjustment, RAF methodology, utilization management, and medical cost management.
• Experience developing provider scorecards, performance improvement plans, and corrective action strategies.
• Advanced proficiency in Microsoft Excel and PowerPoint
• Strong analytical, presentation, communication, facilitation, and negotiation skills
• Ability to translate complex clinical, operational, and financial data into actionable provider strategies
• Knowledge of applicable federal, state, CMS, and contractual requirements governing provider networks and healthcare programs

Responsibilities

• Develop and execute provider engagement and performance improvement strategies aligned with organizational and market goals.
• Lead provider-facing initiatives focused on quality improvement, risk adjustment, utilization management, value-based care performance, and financial sustainability.
• Partner with provider organizations to drive practice transformation, workflow optimization, care coordination, and population health management initiatives.
• Monitor provider performance against key metrics and develop action plans to improve quality outcomes, coding accuracy, documentation, utilization, and cost of care.
• Serve as a strategic advisor and executive sponsor for key provider organizations and partnerships.
• Collaborate with internal teams to address provider operational issues related to claims, authorizations, credentialing, rosters, directory accuracy, and delegated services.
• Support network development, provider retention, network optimization, and market expansion initiatives.
• Lead provider education efforts related to HEDIS, CMS Star Ratings, risk adjustment, value-based care programs, and regulatory requirements.
• Analyze provider, clinical, operational, utilization, and financial performance data to identify trends and improvement opportunities.
• Develop executive-level reporting and present provider performance updates, recommendations, and strategic initiatives to leadership and stakeholders.
• Lead, mentor, and develop Provider Relations Managers and market-based provider engagement teams.
• Foster a culture of accountability, collaboration, continuous improvement, and performance excellence

Skills

Provider Leadership

Value-Based Care

Population Health

HEDIS Expertise

RAF Methodology

Excel

Data Analytics

Contracting Skills

Education

Bachelor's degree (Healthcare Administration/related)

Master's degree (Healthcare Administration/related)

Job description

Astrana Health Management is seeking a Director, Provider Relations to lead a dynamic team and drive engagement, performance improvement, and value-based care strategies across markets. This senior role partners with cross-functional teams to improve quality, risk adjustment, and financial outcomes.

The position requires deep expertise in provider operations, managed care, and population health, with a focus on collaboration, strategic advisory, and market expansion. Travel may be required.