Provider Relations Manager

Salud Healthcare; Florida; Presencial; USD 110.000 - 150.000; Jornada completa

Descripción de la vacante

Salud Healthcare is seeking a Provider Relations Manager to own the value-based care performance of a portfolio of physician practices across South Florida. You will serve as the primary strategic partner, guiding practices from go-live forward and ensuring improvement in quality, risk adjustment, and visit completion.

You will turn data into action, helping physicians leverage insights to close care gaps, strengthen workflows, and succeed in Medicare Advantage and other value-based

Formación

• Five or more years of experience in provider relations, practice operations, managed care account management, healthcare consulting, or a related field, including at least three years focused on value-based care.
• Demonstrated track record of strong performance: meeting or exceeding targets for quality, risk adjustment, visit completion, or shared savings.
• Hands-on experience supporting providers in value-based contracts (Medicare Advantage risk, ACOs, shared savings, capitation).
• Strong knowledge of HEDIS, CMS Star Ratings, HCC risk adjustment, and RAF methodology.
• Ability to interpret performance data and translate insights into action.
• Proven ability to work independently and manage multiple practices.

Responsabilidades

• Own end-to-end value-based care performance for an assigned portfolio of provider practices, with accountability for quality, risk adjustment, utilization, and financial results.
• Build a deep understanding of each practice’s workflows, decision-makers, barriers, and operational needs.
• Diagnose why performance opportunities are not moving, including HEDIS and Star measure gaps, HCC recapture, and visit completion; drive resolution.
• Implement and reinforce workflows across annual wellness visits, care gaps, risk opportunities, referrals, and provider actions.
• Lead practice performance reviews with physicians and practice leadership; set targets and track commitments.
• Translate cross-functional work from quality, risk adjustment, care management, and analytics into actionable requests for practices.
• Escalate barriers that require internal action and see them through to resolution.
• Capture field intelligence; identify patterns and recommend workflow and program improvements for the broader network.
• Serve as a subject-matter resource and informal mentor on value-based care strategy and practice engagement.

Conocimientos

Provider relations

Value-based care

HEDIS & Star ratings

RAF methodology

Data interpretation

Communication

Independent worker

Travel willingness

Spanish language (preferred)

Herramientas

EMRs

CRM systems

Analytics platforms

Descripción del empleo

Salud Healthcare is a tech-forward Value Services Organization built to make value-based care work for payors, providers, and patients. We bring together data intelligence, care enablement, risk adjustment, quality, and provider partnerships into one connected operating model. Our partners do not just receive reports or recommendations. They receive the infrastructure, insight, and hands-on support needed to improve performance and deliver better care. We are serious about outcomes, direct in how we work, and deeply invested in the practices and communities we serve.

The Opportunity

This is not a relationship-maintenance role, and it is not a people-management role.

As a Provider Relations Manager, you will be a senior individual contributor who owns the value-based care performance of a portfolio of physician practices across South Florida. You will not lead a team. You will lead outcomes. Your success is measured by how your practices perform in their value-based contracts: quality scores, risk adjustment accuracy, visit completion, care gap closure, and shared savings.

You will serve as the primary strategic and operational partner for each practice from go-live forward, and the person physicians and practice leaders trust to tell them what is happening, why it matters, and what needs to change. You will know your practices beyond the surface. Their workflows. Their barriers. Their performance. Their opportunities. Their people. Your job is to turn information into action, and action into results. That means helping physicians and practice teams use data to improve patient engagement, close care gaps, strengthen workflows, increase visit completion, support accurate documentation, and succeed in Medicare Advantage and other value-based arrangements. We are looking for someone with a proven record of strong performance in value-based care: someone who has moved the numbers before and can show us how.

What You’ll Do

• Own end-to-end value-based care performance for an assigned portfolio of provider practices, with accountability for quality, risk adjustment, utilization, and financial results.
• Build a deep understanding of each practice’s workflows, decision-makers, barriers, and operational needs.
• Diagnose why performance opportunities are not moving, including HEDIS and Star measure gaps, HCC recapture, and visit completion, and drive the right path to resolution.
• Implement and reinforce workflows across annual wellness visits, care gaps, risk opportunities, referrals, and provider actions.
• Lead practice performance reviews with physicians and practice leadership, set clear targets, track commitments, and hold practices accountable to agreed actions.
• Translate cross-functional work from quality, risk adjustment, care management, and analytics into clear, credible, and actionable requests for practices.
• Escalate barriers that require internal action and see them through to resolution.
• Capture field intelligence, identify patterns across your portfolio, and recommend workflow and program improvements for the broader network.
• Serve as a subject-matter resource and informal mentor to peers on value-based care strategy and practice engagement, without formal supervisory responsibility.

Qualifications

Required

• Five or more years of experience in provider relations, practice operations, managed care account management, healthcare consulting, or a related field, including at least three years focused on value-based care.
• Demonstrated track record of strong performance: consistently meeting or exceeding targets for quality, risk adjustment, visit completion, or shared savings across a portfolio of practices or accounts.
• Hands‑on experience supporting providers in value-based contracts, such as Medicare Advantage risk arrangements, ACOs, shared savings, or capitation.
• Strong working knowledge of HEDIS, CMS Star Ratings, HCC risk adjustment, and RAF methodology.
• Ability to interpret performance data, lead credible conversations with physicians and practice leaders, and turn insights into measurable action.
• Proven ability to work independently, manage priorities across multiple practices, and drive results without direct authority.
• Strong relationship‑building, communication, problem‑solving, and follow‑through skills.
• Valid driver’s license and ability to travel regularly throughout South Florida.

Preferred

• Experience with an MSO, ACO, VSO, health plan, or value-based provider organization.
• Experience with workflow redesign, quality improvement, or practice transformation.
• Proficiency with EMRs, CRM systems, and analytics platforms.
• Bilingual English and Spanish strongly preferred.

Why Salud.

We hire against five values, and they describe how we actually work. Be Bold — challenge the status quo and act with urgency, even when the path is uncertain. Be Selfless — put patients, partners, and teammates first, and share the credit. Be Authentic — bring your whole self, and give honest, candid feedback. Be Accountable — own the outcome and answer for it. Deliver Results — measure what counts, and push until the numbers actually move.

Salud Healthcare provides equal employment opportunities to all employees and applicants for employment, and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex (including pregnancy, sexual orientation, and gender identity or expression), national origin, disability status, genetic information, citizenship status, protected veteran status, marital status, or any other characteristic protected by federal, state, or local law.