Sr Director Provider Relations

Overall Purpose

The Senior Director Provider Relations is responsible for the strategic leadership development and oversight of provider relationship management across P3 Health Partners markets. This role leads initiatives to strengthen provider engagement optimize provider satisfaction and performance and foster collaborative partnerships with physicians hospitals ancillary providers and health system partners in support of organizational growth and value-based care initiatives.

The Senior Director serves as a strategic liaison between providers and internal operational clinical network and executive leadership teams to ensure alignment with organizational objectives regulatory requirements quality initiatives and financial performance. This leader is responsible for developing provider engagement strategies resolving complex provider issues supporting network performance and driving continuous improvement in provider experience and operational effectiveness.

Essential Functions

• Provides strategic leadership for Provider Relations operations across assigned markets ensuring alignment with organizational goals value-based care initiatives and enterprise growth strategies.
• Develops and executes enterprise-wide provider engagement and communication strategies that strengthen relationships with physicians medical groups hospitals ancillary providers and health system partners.
• Leads develops and mentors high-performing Provider Relations teams through recruitment coaching performance management succession planning and professional development.
• Serves as the executive point of contact for contracted providers regarding complex operational reimbursement payment and contractual issues ensuring timely resolution while maintaining strong provider relationships.
• Collaborates closely with Network Contracting Medical Management Clinical Operations Quality Finance Claims Operations and Executive Leadership to support provider performance operational excellence and organizational objectives.
• Partners with Network Contracting during provider negotiations contract implementation acquisitions and network expansion initiatives to ensure successful provider onboarding contract execution and long-term provider engagement.
• Provides strategic oversight to ensure contracted providers are reimbursed in accordance with negotiated contract terms and reimbursement methodologies by partnering with Claims Operations Network Contracting and Finance to identify trends resolve systemic issues and improve provider satisfaction.
• Oversees provider payment escalations and reimbursement concerns serving as the executive liaison between contracted providers and internal operational teams to facilitate timely and accurate issue resolution.
• Ensures delegated reimbursement policies contractual obligations and operational reimbursement processes are consistently implemented and adhered to across the organization while partnering with internal stakeholders to drive compliance and continuous improvement.
• Develops and monitors provider satisfaction metrics identifies performance trends and implements strategic action plans to improve provider experience operational effectiveness and provider retention.
• Leads provider education initiatives related to value-based care quality programs risk adjustment STARS HEDIS clinical documentation improvement (CDI) reimbursement methodologies operational workflows and health plan requirements.
• Oversees the development of provider performance dashboards scorecards executive reporting and strategic analyses to support organizational decision-making.
• Establishes and monitors key performance indicators (KPIs) related to provider satisfaction provider engagement provider reimbursement performance issue resolution operational effectiveness and network performance.
• Identifies opportunities to improve provider access network effectiveness reimbursement processes operational workflows and cross-functional collaboration.
• Partners with executive leadership on strategic initiatives acquisitions market expansion provider integration and enterprise-wide provider engagement programs.
• Develops departmental goals budgets strategic initiatives and performance metrics while monitoring operational and financial performance.
• Establishes enterprise-wide policies governance best practices and standardized Provider Relations processes across all markets.
• Represents the organization in executive meetings with provider organizations physician leadership hospitals health systems accountable care organizations (ACOs) and health plan partners.
• Ensures compliance with applicable federal state CMS delegated entity contractual and regulatory requirements impacting provider relationships and reimbursement activities.
• Promotes the mission vision and values of P3 Health Partners.

Knowledge Skills and Abilities

• Extensive knowledge of provider relations managed care operations provider engagement strategies value-based care healthcare delivery systems and delegated healthcare models.
• Strong understanding of provider reimbursement methodologies claims adjudication processes delegated reimbursement models managed care contracting principles Medicare Advantage population health risk adjustment STARS HEDIS quality improvement programs and healthcare operations.
• Demonstrated executive-level relationship management negotiation conflict resolution and provider advocacy skills.
• Exceptional communication presentation and executive influence skills with the ability to build trusted relationships across all levels of the organization and with physicians hospitals health systems ancillary providers and health plans.
• Proven ability to develop and execute enterprise-wide strategic initiatives and successfully lead organizational change.
• Strong analytical financial and problem-solving skills utilizing provider performance reimbursement operational and financial data.
• Experience developing executive dashboards provider scorecards strategic reporting and performance analytics.
• Ability to establish performance metrics and drive continuous operational and process improvement.
• Strong organizational leadership coaching mentoring and talent development skills.
• Ability to manage multiple priorities within a complex fast-paced matrixed healthcare environment.
• Advanced proficiency with Microsoft Office applications including Excel PowerPoint reporting tools and business intelligence platforms.

Experience

• Minimum of 10 years of progressive leadership experience in provider relations managed care provider network operations healthcare administration or related healthcare leadership roles.
• Minimum of 5 years leading Provider Relations or Network Management teams.
• Demonstrated success building and maintaining executive-level relationships with physicians hospitals health systems medical groups ancillary providers and health plans.
• Experience supporting value-based care models provider performance improvement initiatives and provider engagement strategies.
• Experience working with Medicare Advantage managed care organizations accountable care organizations (ACO) or delegated healthcare models strongly preferred.

Education

• Bachelors degree in Healthcare Administration Business Administration Public Health or a related field required.
• Masters degree (MBA MHA MPH or related field) strongly preferred.

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 organizations networks.

Work Location & Schedule
This role offers a hybrid work arrangement. Candidates will follow our hybrid schedule working in office three days per week.

Pay range: $00 depending on experience

About P3

People. Passion. Purpose.

At P3 Health Partners our promise is to guide our communities to better health unburden clinicians align incentives and engage patients. We are a physician-led organization relentless in our mission to overcome all obstacles by positively disrupting the business of health care transforming it from sickness care into wellness guidance. If you are passionate about your work; eager to have fun; and motivated to be part of a fast-growing organization then you should consider joining our team.

Required Experience:

Exec