Hybrid Value-Based Provider Relations Specialist

Astrana Health, Inc.; Houston (TX); Hybrid; USD 75,000 - 85,000; Full time

Job summary

Astrana Health, Inc. is seeking a Market Provider Relations Specialist to support IPA operations and provider engagement in the Houston area. This field-based role acts as the primary liaison, driving performance, education, and relationship management with physician practices.

The candidate will bring analytical skills and experience in value-based care to enhance documentation, risk adjustment, and care quality, while collaborating with cross-functional teams to achieve organizational goals.

Qualifications

• Bachelor's degree preference or equivalent healthcare experience.
• Minimum of three (3) years of experience in provider relations, healthcare operations, managed care, practice management, quality improvement, population health, risk adjustment, or related healthcare field.
• Experience working directly with physician practices preferred
• Experience supporting value-based care programs preferred
• Knowledge of provider office operations and healthcare delivery models
• Working knowledge of HEDIS, CMS Star Ratings, quality improvement, and risk adjustment principles
• Understanding of managed care, Medicare Advantage, ACOs, IPA operations, or population health programs preferred
• Strong analytical skills with the ability to interpret provider performance data and translate findings into actionable recommendations
• Strong relationship-building, communication, presentation, and facilitation skills
• Strong organizational and project management abilities with the ability to manage multiple priorities and deadlines
• Proficiency with Microsoft Office applications and reporting tools

Responsibilities

• Serve as the primary point of contact for assigned provider practices and build strong relationships with physicians, office managers, practice administrators, and clinical staff
• Conduct provider meetings and site visits to review performance, discuss initiatives, address challenges, and support improvement efforts
• Support provider engagement, practice transformation, quality improvement, risk adjustment, utilization management, and value-based care initiatives
• Educate providers and practice staff on HEDIS, CMS Star Ratings, risk adjustment, documentation requirements, population health, and quality improvement programs
• Review provider performance reports and scorecards, identify improvement opportunities, and assist with development of action plans
• Support providers in improving documentation accuracy, coding practices, care gap closure, chronic disease management, and patient outcomes
• Assist with operational questions related to claims, referrals, authorizations, credentialing, provider data, and other provider service functions
• Partner with Quality, Risk Adjustment, Care Management, Medical Management, Claims, Contracting, Credentialing, and Operations teams to support provider success
• Monitor provider engagement activities, maintain accurate documentation, and provide updates on market and provider performance
• Support implementation of new programs, payer initiatives, regulatory requirements, and organizational priorities

Skills

Strong analytical skills

Relationship-building

Communication

Presentation skills

Facilitation skills

Project management

Microsoft Office

Education

Bachelor's degree in Healthcare Administration, Public Health, Nursing, Business Administration, or related field

Tools

Reporting tools

Job description

Astrana Health, Inc. is seeking a Market Provider Relations Specialist to support IPA operations and provider engagement in the Houston area. This field-based role acts as the primary liaison, driving performance, education, and relationship management with physician practices.

The candidate will bring analytical skills and experience in value-based care to enhance documentation, risk adjustment, and care quality, while collaborating with cross-functional teams to achieve organizational goals.