Remote Provider Relations Lead — Performance & Growth

SCAN; Long Beach (CA); À distance; USD 72 000 - 123 000; Plein temps

Avantages offerts par ce poste

Base salary range

Internal title: Provider Relations II

Mostly Remote

Annual bonus program

Wellness program

Generous PTO

11 holidays + floating + birthday

401(k) with employer match

Recognition program

Tuition reimbursement

Résumé du poste

SCAN, a nonprofit health organization serving seniors, is seeking a Provider Relations Lead to strengthen relationships with MSOs, IPAs, and hospitals across Southern California. You will drive performance initiatives, ensure regulatory compliance, and coordinate cross-functional teams to improve care delivery and cost management.

The role emphasizes quarterback-style provider management, proactive issue resolution, and education to align performance with SCAN’s standards.

Qualifications

• 5 years of healthcare or Medicare Advantage experience.
• Bachelor's Degree or equivalent experience preferred.
• Provider relationship management with various provider types.
• Data interpretation and performance analysis skills.
• Medicare Advantage and Star quality knowledge.
• CMS regulatory and compliance awareness.

Responsabilités

• Acts as the primary operational liaison between SCAN and provider organizations within a defined geographic region.
• Manage FFS network for Southern California.
• Execute and monitor regional provider performance initiatives (Star ratings, cost of care, utilization, access, quality).
• Conduct regular operational touchpoints and Joint Operating Committee meetings.
• Partner cross-functionally with Network Contracting, Network Operations, Clinical, Quality, Growth, and Analytics teams.
• Support provider onboarding and lifecycle management with Contracting and Operations.
• Investigate and resolve provider escalations and issues; escalate to senior leadership when needed.
• Deliver provider education and training on SCAN programs and regulatory requirements.
• Analyze provider-level data to identify trends and opportunities; support corrective action plans.

Connaissances

Provider relations

Data interpretation

Presentation skills

Cross-functional collaboration

Account management

Regulatory awareness

Analytical thinking

Communication skills

Formation

Bachelor's degree or equivalent

Outils

MS Office

Visio

Description du poste

SCAN, a nonprofit health organization serving seniors, is seeking a Provider Relations Lead to strengthen relationships with MSOs, IPAs, and hospitals across Southern California. You will drive performance initiatives, ensure regulatory compliance, and coordinate cross-functional teams to improve care delivery and cost management.

The role emphasizes quarterback-style provider management, proactive issue resolution, and education to align performance with SCAN’s standards.