Provider Relations Lead

Job Description

SCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adults in the United States. SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation's leading not-for-profit Medicare Advantage plans, serving more than 277,000 members in California, Arizona, Nevada, Texas and New Mexico. SCAN has been a mission-driven organization dedicated to keeping seniors healthy and independent for more than 45 years and is known throughout the healthcare industry and nationally as a leading expert in senior healthcare.

SCAN employees are a group of talented, passionate professionals who are committed to supporting older adults on their aging journey, while also innovating healthcare for seniors everywhere. Employees are provided in-depth training and access to state-of-the-art tools necessary to do their jobs, as well as development and growth opportunities. SCAN takes great pride in recognizing our team members as experts in their fields and rewarding them for their efforts.

If you are interested in becoming part of an organization that is innovating senior healthcare visit (Use the "Apply for this Job" box below). , or follow us on Linked In, Facebook, and Twitter.

The Provider Relations Lead will be responsible for building and maintaining effective provider relationships with medical groups, primary care physicians, specialists, hospitals and ancillaries. The Provider Relations Lead may focus on a particular provider type or geographic region, but will have skillsets to be agnostic and flexible based on business needs.

The job entails partnering closely with Contracting counterparts to facilitate an integrated onboarding process, conducting provider awareness and orientation about SCAN Health Plan, ongoing education and outreach, relationship building with office staff and providers, and quarterbacking the overall relationship including acting as the liaison with cross-functional stakeholders across reporting needs, performance monitoring, issue resolution, and clinical programs or growth efforts with the group/provider.

There will be daily interface with office staff and providers, as well as interactions with corporate leadership at medical groups and constant collaboration with internal stakeholders to effectively establish and maintain a positive provider experience and resolve escalated issues in a timely manner.

• This position will perform work under no/minimal supervision while handling complex issues and problems and work complex issues with managers.
• The Provider Relations Lead will serve as primary contact for medical groups, providers, hospitals and ancillaries and act as a key liaison between the providers/entities and the health plan.
• Closely partners with Contracting to facilitate an integrated onboarding experience, leading project management planning for cross-functional onboarding efforts and establishing a robust playbook.
• Establish and maintain excellent relationships with the provider network, with efforts focused on a particular region in which the Lead is based locally.
• The Provider Relations Lead conducts office staff and provider orientation, on-going education, training and relationship building both virtually and via onsite visits.
• Conducts regular provider office visits within assigned geographic region.
• Investigates and responds to escalated provider concerns and issues.
• The Provider Relations Lead participates in data driven operations meetings with assigned network of providers, corporate leadership and internal SCAN stakeholders.
• Creates educational materials and formal presentations to support provider touchpoints and initiatives.
• Supports cost and quality performance monitoring of the provider network, and liaison for trainings on deficiencies.
• Coordinates data extracts and data analysis interpretation.
• Partners with Contracting on network adequacy and robustness of local provider access and reputation to evaluate the need for additional providers; supports on internal awareness of network changes.
• Acts as a key liaison for network needs to support clinical programs or growth efforts.
• The Provider Relations…