Remote Provider Relations Leader for Care Performance

Scan-Health-Plan; Long Beach (CA); On-site; USD 72,000 - 123,000; Full time

Benefits offered by this job

Annual bonus program

Wellness program

PTO

11 holidays + floating birthday

401(k) with match

Tuition reimbursement

Job summary

SCAN Health Plan is seeking a Provider Relations Lead to strengthen relationships with MSOs, IPAs, medical groups, PCPs, specialists, hospitals, and ancillaries across Southern California. You will drive performance initiatives, ensure regulatory compliance, and coordinate with clinical, quality, and operations teams to achieve KPIs.

The role emphasizes account management, education, and proactive issue resolution while supporting onboarding and lifecycle management of provider networks.

Qualifications

• 5 years of healthcare or Medicare Advantage experience.
• Experience with provider organizations or healthcare operations.
• Experience with delegated or risk-based provider arrangements.
• Data interpretation and performance analysis skills.
• Medicare Advantage and Star quality knowledge.
• CMS regulatory and compliance awareness.
• Strong written and verbal communication and interpersonal skills.
• Cross functional collaboration and multi-tasking abilities.

Responsibilities

• Act as the primary operational liaison between SCAN and provider organizations within a defined geographic region.
• Execute and monitor regional provider performance initiatives aligned to KPIs such as Star ratings and cost of care.
• Conduct regular operational touchpoints and Joint Operating Committee meetings with providers.
• 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 high-risk issues.
• Deliver provider education and training related to SCAN programs and regulatory requirements.
• Analyze provider-level data to identify trends and opportunities for improvement.

Skills

Provider relationship management

Data interpretation

Presentation skills

Cross-functional collaboration

Problem solving

Education

Bachelor's degree or equivalent experience

Tools

Microsoft Office

Visio

Job description

SCAN Health Plan is seeking a Provider Relations Lead to strengthen relationships with MSOs, IPAs, medical groups, PCPs, specialists, hospitals, and ancillaries across Southern California. You will drive performance initiatives, ensure regulatory compliance, and coordinate with clinical, quality, and operations teams to achieve KPIs.

The role emphasizes account management, education, and proactive issue resolution while supporting onboarding and lifecycle management of provider networks.