[Hiring] Sr. Provider Relations Lead @SCAN Health Insurance

Role Description

The Senior Provider Relations Lead is responsible for the strategic development, governance, and sustainment of high-impact provider relationships across medical groups, primary care physicians, specialists, hospitals, and ancillary providers. This role operates with a high degree of autonomy and strategic judgment, with responsibility for a defined provider portfolio in a geographic region, while maintaining the agility to support enterprise priorities and evolving business needs.

• Serves as a senior partner to Network Contracting and other cross-functional internal stakeholders to ensure an integrated, seamless provider experience and lifecycle management experience.
• Leads provider education and orientation efforts related to SCAN Health Plan programs, policies, and performance expectations.
• Drives ongoing engagement, relationship stewardship, and performance KPIs.
• Acts as the primary first line of engagement as well as escalation point and strategic liaison across cross-functional teams.
• Understands the nuanced dynamics within a provider organization and independently navigates to meet objectives needed for the partnership.
• Excels at account management skills including the ability to project manage multiple complex tasks or issues.
• Demonstrates critical thinking, proactiveness, and creative problem solving.
• Engages regularly with both front-line office staff and executive leadership at medical groups and provider practices.
• Accountable for proactively identifying risks, resolving complex and escalated issues, aligning stakeholders, and ensuring a consistently positive provider experience.

Qualifications

• 7 years of prior relevant experience.
• Ability to build, sustain, and leverage executive-level provider relationships to drive performance improvement and operational alignment.
• Proven ability to analyze performance data, identify gaps, and drive targeted improvement strategies across cost, quality, access, and operational metrics.
• Demonstrated ability to understand the “who” and the “what” within complex organizations, navigate decision-making structures, and influence outcomes across multiple stakeholders.
• Ability to lead and align cross-functional teams without direct authority to achieve shared performance objectives.
• Expertise in diagnosing multifaceted provider issues, conducting root cause analysis, and implementing sustainable, system-level solutions.
• Strong ability to interpret complex data, translate insights into actionable recommendations, and drive accountability through performance metrics and KPIs.
• Ability to drive behavior change among providers and internal stakeholders.
• Advanced written and verbal communication skills, including the ability to deliver executive-ready presentations.
• Proven ability to lead high-impact initiatives, prioritize competing demands, and deliver measurable outcomes in a matrixed environment.
• Ability to coach, guide, and mentor Provider Relations Leads.
• Strong understanding of healthcare regulatory requirements, contractual frameworks, and compliance standards impacting provider networks.
• Demonstrated ability to operate independently with sound judgment.
• Ability to travel regularly to provider offices and sites within assigned region.

Requirements

• Operates with minimal to no supervision, exercising advanced judgment to manage complex, high-impact provider relations issues.
• Serves as the primary strategic contact and escalation point for assigned IPA/medical groups, PCPs, specialists, hospitals, and ancillary partners.
• Owns provider engagement strategy for an assigned region, provider type, or strategic portfolio.
• Builds and sustains executive-level relationships with provider leadership and key office staff.
• Partners with Contracting to identify, engage, and support potential contracting opportunities.
• Leads provider orientation, ongoing education, and training initiatives.
• Drives cross-functional performance initiatives across various teams.
• Investigates, resolves, and mitigates complex and escalated provider issues.
• Facilitates and leads data-driven operational and performance discussions.
• Actively drives provider performance by identifying trends, risks, and opportunities.
• Provides coaching, guidance, and mentorship to Provider Relations Leads.
• Ensures alignment with regulatory, contractual, and compliance requirements.

Benefits

• Base Pay Range: $80,300 - $138,330 Annually.
• Work Mode: Mostly Remote.
• An annual employee bonus program.
• Robust Wellness Program.
• Generous paid-time-off (PTO).
• 11 paid holidays per year, plus 1 additional floating holiday.
• Excellent 401(k) Retirement Saving Plan with employer match.
• Robust employee recognition program.
• Tuition reimbursement.
• An opportunity to become part of a team that makes a difference to our members and our community every day!