Overall PurposeThe Provider Relations Manager is responsible for developing and maintaining collaborative relationships with contracted primary care providers, clinic leadership, office managers, and practice staff across P3 Health Partners' provider network. This role serves as the primary operational liaison between provider practices and internal departments to support value-based care initiatives, operational excellence, and provider satisfaction.
Working collaboratively with Care Management, Quality, Risk Adjustment & Clinical Documentation (RACD), Compliance, Clinical Operations, Claims Operations, and Network Contracting, the Provider Relations Manager facilitates communication, resolves operational issues, supports provider education, and drives initiatives that improve provider performance, patient outcomes, regulatory compliance, and organizational goals. This position plays a critical role in ensuring providers are engaged, informed, and equipped to successfully participate in P3's delegated care model.
Essential Functions- Develop and maintain strong working relationships with physicians, advanced practice providers, clinic leadership, office managers, and practice staff within assigned provider networks.
- Serve as the primary operational liaison between provider practices and internal departments to facilitate communication, collaboration, and issue resolution.
- Partner with Care Management, Quality, Risk Adjustment & Clinical Documentation (RACD), Compliance, Clinical Operations, Claims Operations, and Network Contracting to support provider performance and operational initiatives.
- Conduct routine provider office visits to strengthen relationships, assess operational needs, communicate organizational initiatives, and identify opportunities for improvement.
- Collaborate with providers to improve quality outcomes, risk adjustment performance, clinical documentation, care coordination, patient access, and operational efficiency.
- Educate providers and office staff on value-based care initiatives, quality programs, HEDIS, STARS, Risk Adjustment, Clinical Documentation Improvement (CDI), delegated responsibilities, and organizational workflows.
- Coordinate implementation of new operational initiatives, regulatory requirements, policies, and process improvements within provider practices.
- Investigate and resolve provider concerns related to operational workflows, claims, referrals, authorizations, eligibility, provider data, and other delegated services through collaboration with internal business partners.
- Monitor provider satisfaction and proactively identify trends or concerns that may impact provider engagement, operational effectiveness, or network performance.
- Support onboarding and orientation of newly contracted providers to ensure successful implementation of P3 operational processes and delegated responsibilities.
- Analyze provider performance reports and operational metrics to identify improvement opportunities and assist providers in developing action plans.
- Facilitate communication between provider practices and internal operational teams to ensure timely follow-up, accountability, and resolution of provider concerns.
- Maintain documentation of provider interactions, issue resolution, provider education, and follow-up activities.
- Participate in cross-functional committees, operational work groups, and provider engagement initiatives that support organizational objectives.
- Ensure provider interactions and operational activities comply with applicable federal, state, CMS, contractual, delegated entity, and organizational requirements.
- Promote the mission, vision, and values of P3 Health Partners.
Knowledge, Skills and Abilities- Knowledge of provider relations, managed care operations, delegated healthcare models, and value-based care principles.
- Understanding of Medicare Advantage, population health, HEDIS, STARS, Risk Adjustment, Clinical Documentation Improvement (CDI), and quality improvement initiatives.
- Strong relationship-building skills with the ability to establish credibility and trust with physicians, clinic leadership, and office staff.
- Excellent verbal, written, presentation, and interpersonal communication skills.
- Strong problem-solving, conflict resolution, and customer service skills.
- Ability to collaborate effectively across multiple departments in a matrixed healthcare environment.
- Ability to analyze provider performance data and identify operational improvement opportunities.
- Strong organizational skills with the ability to manage multiple priorities and competing deadlines.
- Proficiency with Microsoft Office applications, including Excel, PowerPoint, and reporting tools.
- Ability to maintain confidentiality and exercise sound judgment in sensitive situations.
Experience- Minimum of five (5) years of experience in Provider Relations, Provider Network Operations, Managed Care, Practice Management, Healthcare Operations, or a related healthcare environment.
- Experience working with physicians, provider organizations, or medical practices required.
- Experience supporting Medicare Advantage, delegated healthcare models, Accountable Care Organizations (ACOs), or value-based care initiatives preferred.
- Previous leadership or supervisory experience preferred.
Education- Bachelor's degree in Healthcare Administration, Business Administration, Public Health, Nursing, or a related field required.
Travel- Must have ability to travel. Travel will be required to engage with potential providers, develop relationships with physicians, clinical teams, etc. and overall building of the organization's networks.
Work Location & ScheduleThis role offers a hybrid work arrangement. Candidates will follow our hybrid schedule, working in office three days per week.
Pay Range: $105,000-119,000 depending on experience
