Provider Relations Lead, Washington

SHPCA SCAN Health Plan; Washington; Hybrid; USD 71,700 - 123,490; Full time

Benefits offered by this job

Annual employee bonus program

Generous paid-time-off (PTO)

401(k) retirement savings plan with employer match

Tuition reimbursement

Job summary

SHPCA SCAN Health Plan is seeking a Provider Relations Lead in Washington to manage and strengthen provider relationships across the region. You will drive performance initiatives based on quality, cost, and utilization metrics.

The ideal candidate has 5+ years of healthcare experience, strong communication skills, and will engage with various provider organizations. The role offers flexible remote work and an array of benefits including generous PTO and a bonus program.

Qualifications

• At least 5 years of relevant healthcare or Medicare Advantage experience.
• Experience working with provider organizations or healthcare operations.
• Strong ability to partner across various functions.

Responsibilities

• Act as the primary operational liaison between SCAN and provider organizations.
• Execute and monitor regional provider performance initiatives.
• Investigate and resolve provider escalations and operational concerns.

Skills

Healthcare experience

Provider relations

Data analysis

Communication

Problem-solving

Education

Bachelor’s degree or equivalent

Job description

Provider Relations Lead – Washington

SCAN is a nonprofit health organization serving more than 500,000 adults across Arizona, California, Nevada, New Mexico, Texas, and Washington. The Provider Relations Lead – Washington is responsible for managing and strengthening provider relationships within an assigned geographic region and driving performance initiatives across quality, cost, utilization, access, and regulatory metrics.

Responsibilities

• Act as the primary operational liaison between SCAN and provider organizations (MSOs, IPAs, medical groups, PCPs, specialists, hospitals, and ancillary services) within the defined region.
• Execute and monitor regional provider performance initiatives aligned to SCAN’s key performance indicators, including Star ratings, cost of care, utilization management, access standards, and quality measures.
• Conduct regular operational touchpoints and Joint Operating Committee meetings with providers to review performance results, identify gaps, and support action planning.
• Partner cross‑functionally with Network Contracting, Network Operations, Clinical, Quality, Growth, and Analytics teams to coordinate provider engagement and resolve issues.
• Support provider onboarding and lifecycle management in collaboration with Contracting and Operations to ensure clarity of performance expectations and operational readiness.
• Investigate and resolve provider escalations and operational concerns; appropriately escalate complex or high‑risk issues to senior leadership.
• Deliver provider education and training related to SCAN programs, policies, regulatory requirements, performance standards, and operational best practices.
• Analyze provider‑level data to identify trends and opportunities, supporting corrective action plans and continuous performance improvement efforts.
• Utilize operational levers such as workflow optimization and process enhancements to drive performance improvements.
• Ensure provider alignment with regulatory, contractual, and compliance requirements while proactively identifying potential risk areas.
• Support internal communication of network changes, provider performance updates, and market‑level insights to relevant enterprise stakeholders.

Qualifications

• Bachelor’s degree or equivalent experience.
• At least 5 years of relevant healthcare or Medicare Advantage experience.
• Experience working with provider organizations or healthcare operations.
• Experience with delegated or risk‑based provider arrangements.
• Experience supporting provider performance improvement initiatives.
• Experience presenting data to provider or operational audiences.
• Strong technical skills related to the functional area.
• Strong problem‑solving skills and critical‑thinking capabilities.
• Excellent communication and interpersonal skills.
• Strong ability to partner with a variety of functions across the enterprise.
• Strong experience developing relationships with all provider types.

Benefits

• Base pay range: $71,700 – $123,490 annually
• Mostly remote work with travel within the territory
• Annual employee bonus program
• Robust wellness program
• Generous paid‑time‑off (PTO), 11 paid holidays per year and 1 floating holiday
• 401(k) retirement savings plan with employer match
• Employee recognition program
• Tuition reimbursement

Equal Opportunity Statement

SCAN is proud to be an Equal Employment Opportunity and affirmative action workplace. All applicants and employees are considered without regard to race, color, national origin, religion, sex, gender identity or expression, sexual orientation, age, marital status, disability, veteran status, or any other status protected by law. A background check is required for employment.