Director, Provider Services & Value-Based Care

Presbyterian Healthcare Services; Albuquerque (NM); Hybrid; USD 180,000 - 240,000; Full time

Benefits offered by this job

Full medical insurance

PTO and flexible scheduling

Professional development opportunities

Job summary

Presbyterian Healthcare Services is seeking a Director to oversee provider servicing operations and value-based payment programs across our multi-market network. You will drive education, analytics, and performance reporting while advancing the transition to value-based care in collaboration with contracting, medical economics, and clinical operations teams.

The role requires a strategic leader who can optimize total cost of care, strengthen provider relationships, and ensure regulatory

Qualifications

• Bachelor's degree required or 6 years of additional experience substituted for degree.
• 10+ years in provider relations/contracting/claims in managed care, with 5 years of leadership.
• Strong understanding of reimbursement methodologies and robust communication skills.

Responsibilities

• Lead provider servicing operations, issue resolution, and relationship management.
• Provide strategic leadership for value-based payment programs across segments.
• Develop standardized servicing models, workflows, and performance metrics.
• Collaborate on provider communication, training, and engagement initiatives.
• Oversee design and optimization of VBP arrangements and analytics reporting.
• Ensure compliance with CMS, Medicaid, NCQA and related regulations.

Skills

Provider relations

Value-based payments

Healthcare operations

Financial analytics

Public speaking

Education

Bachelor's degree

Job description

Presbyterian Healthcare Services is seeking a Director to oversee provider servicing operations and value-based payment programs across our multi-market network. You will drive education, analytics, and performance reporting while advancing the transition to value-based care in collaboration with contracting, medical economics, and clinical operations teams.

The role requires a strategic leader who can optimize total cost of care, strengthen provider relationships, and ensure regulatory