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Director – Provider Relations
Astrana Health. Develop and execute provider engagement and performance improvement strategies aligned with organizational and market goals .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in provider engagement, performance improvement strategies, and value-based care delivery models. Proficient in analyzing healthcare data to drive practice transformation and optimize provider performance while ensuring compliance with regulatory requirements.
Highest-signal resume keywords
Provider EngagementValue-Based CarePerformance Improvement StrategiesHealthcare Leadership ExperienceHEDIS Knowledge
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Data AnalysisPerformance Improvement PlansUtilization ManagementRisk AdjustmentPractice TransformationProvider ScorecardsFinancial Performance ManagementPopulation Health ManagementClinical Documentation ImprovementEHR Optimization
Soft Skills
Analytical SkillsCommunication SkillsFacilitation SkillsNegotiation SkillsLeadership Skills
Tools & Technologies
Microsoft ExcelMicrosoft PowerPoint
Certifications & Qualifications
CPHQCPCCCSPMPLean Six Sigma
Industry Keywords
Managed CareProvider RelationsPopulation HealthACO OperationsMedicare AdvantageMedicaidValue-Based Care ProgramsCMS Star RatingsFederal and State RegulationsHealthcare Administration
Tech Stack
Tools & technologiesPMP
About the role
Key responsibilities & impact- Develop and execute provider engagement and performance improvement strategies aligned with organizational and market goals
- Lead provider-facing initiatives focused on quality improvement, risk adjustment, utilization management, value-based care performance, and financial sustainability
- Partner with provider organizations to drive practice transformation, workflow optimization, care coordination, and population health management initiatives
- Monitor provider performance against key metrics and develop action plans to improve quality outcomes, coding accuracy, documentation, utilization, and cost of care
- Serve as a strategic advisor and executive sponsor for key provider organizations and partnerships
- Collaborate with internal teams to address provider operational issues related to claims, authorizations, credentialing, rosters, directory accuracy, and delegated services
- Support network development, provider retention, network optimization, and market expansion initiatives
- Lead provider education efforts related to HEDIS, CMS Star Ratings, risk adjustment, value-based care programs, and regulatory requirements
- Analyze provider, clinical, operational, utilization, and financial performance data to identify trends and improvement opportunities
- Develop executive-level reporting and present provider performance updates, recommendations, and strategic initiatives to leadership and stakeholders
- Lead, mentor, and develop Provider Relations Managers and market-based provider engagement teams
- Foster a culture of accountability, collaboration, continuous improvement, and performance excellence
Requirements
What you’ll need- Bachelor's degree in Healthcare Administration, Business Administration, Nursing, Public Health, Finance, or a related field
- Minimum of 8 years of healthcare leadership experience in Provider Relations, Managed Care, Value-Based Care, Population Health, IPA Operations, ACO Operations, or Network Performance
- Minimum of 5 years of progressive leadership experience managing provider-facing teams
- Demonstrated success leading provider performance improvement initiatives
- Experience working with Medicare Advantage, Medicaid, Commercial, and Value-Based Care programs
- Experience managing complex provider networks, delegated arrangements, and strategic provider partnerships
- Strong understanding of physician practice operations, managed care, and value-based care delivery models
- Expertise in practice transformation, provider engagement, population health management, and performance improvement strategies
- Strong knowledge of HEDIS, CMS Star Ratings, risk adjustment, RAF methodology, utilization management, and medical cost management
- Experience developing provider scorecards, performance improvement plans, and corrective action strategies
- Advanced proficiency in Microsoft Excel and PowerPoint
- Strong analytical, presentation, communication, facilitation, and negotiation skills
- Ability to translate complex clinical, operational, and financial data into actionable provider strategies
- Knowledge of applicable federal, state, CMS, and contractual requirements governing provider networks and healthcare programs
- Preferred: Master's degree in Healthcare Administration, Business Administration, Public Health, Nursing, or a related field
- Preferred: Experience with ACO REACH, MSSP, Medicare Advantage, Medicaid, Commercial, and other risk-bearing or value-based arrangements
- Preferred: Experience with clinical documentation improvement and EHR optimization initiatives
- Preferred: Experience supporting new market, payer, product, or provider-network implementations
- Preferred: Professional certification such as CPHQ, CPC, CCS, PMP, Lean Six Sigma, or a similar healthcare or project management credential
Benefits
Comp & perks- Full-time leadership position supporting provider networks and value-based care initiatives across assigned markets
- Frequent use of a computer, telephone, and standard office equipment
- Ability to work in a fast-paced environment while managing multiple priorities and strategic initiatives
- Regular collaboration with providers, executive leadership, health plans, and cross-functional teams
- Travel may be required to support provider engagement, market operations, and business needs