Market Provider Relations Specialist - Houston 1

Astrana Health, Inc.; Houston (TX); Hybrid; USD 75.000 - 85.000; Vollzeit

Zusammenfassung

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.

Qualifikationen

• 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

Aufgaben

• 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

Kenntnisse

Strong analytical skills

Relationship-building

Communication

Presentation skills

Facilitation skills

Project management

Microsoft Office

Ausbildung

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

Tools

Reporting tools

Jobbeschreibung

Market Provider Relations Specialist - Houston 1

Department: Provider Relations

Employment Type: Full Time

Location: 19500 HWY 249, Suite 570 Houston, TX 77070

Reporting To: Karen Holt

Compensation: $75,000 - $85,000 / year

Description

About the Role

We are currently seeking a highly motivated Market Provider Relations Specialist to support our IPA Operations / Provider Relations team at Astrana Health. This field-based role serves as the primary liaison between Astrana Health and assigned provider practices, supporting provider engagement, practice transformation, quality improvement, risk adjustment performance, utilization management, and value-based care initiatives.

The Market Provider Relations Specialist partners closely with physicians, practice leadership, and care teams to identify operational and clinical improvement opportunities, implement value-based care strategies, and support achievement of organizational performance goals. Through provider education, performance analysis, workflow optimization, and ongoing relationship management, this role helps practices improve patient outcomes, documentation accuracy, operational effectiveness, and financial performance.

The ideal candidate is relationship-driven, analytical, and passionate about helping providers succeed in a value-based care environment.

Our Values

• Put Patients First
• Empower Entrepreneurial Provider and Care Teams
• Operate with Integrity & Excellence
• Be Innovative
• Work As One Team

What You'll Do

• 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

Qualifications

• Bachelor's degree in Healthcare Administration, Public Health, Nursing, Business Administration, or a related field preferred, or an equivalent combination of education and relevant 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 a 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

Preferred Qualifications

• Experience supporting provider performance improvement initiatives
• Experience working within Medicare Advantage, Medicaid, ACO, IPA, or other value-based care models
• Experience with provider education, workflow optimization, and practice transformation initiatives
• Familiarity with utilization management, population health, and care coordination programs

Environmental Job Requirements and Working Conditions

• Our organization follows a hybrid work structure where the expectation is to work in-office and remotely on a weekly basis. The office is located at 19500 Highway 249, Suite 570, Houston, TX 77070.
• Regular travel throughout the assigned market, including visits to provider offices, clinics, and community locations, may be required.
• Ability to attend provider meetings, trainings, and market events as needed.
• The target pay range for this role is $75,000-$85,000 per year. Actual compensation will be determined based on geographic location, experience, qualifications, internal equity, and other job-related factors.