Anaheim, CA, USA
29 days ago
Lead Provider Relations Representative

Under the supervision of the Senior Manager Provider Relations, this position is responsible for physician recruitment related activities and building relationships with Providence contracted physicians/specialist offices. Key responsibilities include Physician office in-services, continuous physician office education, fielding questions, researching and resolving inquiries, identifying issues, management and dissemination of network communications, identifying and vetting new PCP contract opportunities, and overall network performance. This position works with leadership to develop action plan for specific metrics/providers needing improvement, identifies PCP & SPC network gaps, and manages network performance meeting agenda and follow-ups. Activities of this role can impact the open enrollment period, and submission of documentation and recuperation of coding to improve Risk Adjusted Factors (RAF) scores.

Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Medical Foundation and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

Required Qualifications:

Upon request: Driving may be necessary as part of this role. Caregivers are required to comply with all state laws and requirements for driving. Caregivers will be expected to provide proof of driver license and auto insurance upon request. See policy for additional information. 5 years experience in a Provider Relations role working with physicians in Affiliate/IPA, with a minimum 2 of these years at a Senior level Provider Relations role. 5 years Managed care Provider Relations experience.

Preferred Qualifications:

Bachelor’s Degree in Healthcare Management or related field.

Why Join Providence? 

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

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