Director - Provider Relations

Department: ApolloCare TX - Provider RelationsLocation: 19500 HWY 249, Suite 570 Houston, TX 77070Compensation: $85,000 - $130,000 / year Description About the Role We are seeking a highly motivated Director, Provider Relations to support our Provider Relations team at Astrana Health. This senior leadership role is responsible for developing and executing provider engagement, practice transformation, provider performance improvement, and value-based care strategies across assigned markets. The Director serves as the strategic liaison between Astrana Health and contracted provider partners and is accountable for driving improvements in quality performance, risk adjustment, utilization management, provider satisfaction, operational effectiveness, and financial outcomes. This role partners closely with Quality, Risk Adjustment, Operations, Network Development, Contracting, Claims, Clinical Operations, and executive leadership to ensure providers succeed within value-based care arrangements. The ideal candidate is a strategic healthcare leader with deep expertise in provider operations, managed care, population health, and value-based care who is passionate about improving outcomes for patients, providers, and the healthcare system. Our ValuesPut Patients FirstEmpower Entrepreneurial Provider and Care TeamsOperate with Integrity & ExcellenceBe InnovativeWork As One Team What You'll Do Develop and execute provider engagement and performance improvement strategies aligned with organizational and market goalsLead provider-facing initiatives focused on quality improvement, risk adjustment, utilization management, value-based care performance, and financial sustainabilityPartner with provider organizations to drive practice transformation, workflow optimization, care coordination, and population health management initiativesMonitor provider performance against key metrics and develop action plans to improve quality outcomes, coding accuracy, documentation, utilization, and cost of careServe as a strategic advisor and executive sponsor for key provider organizations and partnershipsCollaborate with internal teams to address provider operational issues related to claims, authorizations, credentialing, rosters, directory accuracy, and delegated servicesSupport network development, provider retention, network optimization, and market expansion initiativesLead provider education efforts related to HEDIS, CMS Star Ratings, risk adjustment, value-based care programs, and regulatory requirementsAnalyze provider, clinical, operational, utilization, and financial performance data to identify trends and improvement opportunitiesDevelop executive-level reporting and present provider performance updates, recommendations, and strategic initiatives to leadership and stakeholdersLead, mentor, and develop Provider Relations Managers and market-based provider engagement teamsFoster a culture of accountability, collaboration, continuous improvement, and performance excellence Qualifications Bachelor's degree in Healthcare Administration, Business Administration, Nursing, Public Health, Finance, or a related fieldMinimum of 8 years of healthcare leadership experience in Provider Relations, Managed Care, Value-Based Care, Population Health, IPA Operations, ACO Operations, or Network PerformanceMinimum of 5 years of progressive leadership experience managing provider-facing teamsDemonstrated success leading provider performance improvement initiativesExperience working with Medicare Advantage, Medicaid, Commercial, and Value-Based Care programsExperience managing complex provider networks, delegated arrangements, and strategic provider partnershipsStrong understanding of physician practice operations, managed care, and value-based care delivery modelsExpertise in practice transformation, provider engagement, population health management, and performance improvement strategiesStrong knowledge of HEDIS, CMS Star Ratings, risk adjustment, RAF methodology, utilization management, and medical cost managementExperience developing provider scorecards, performance improvement plans, and corrective action strategiesAdvanced proficiency in Microsoft Excel and PowerPointStrong analytical, presentation, communication, facilitation, and negotiation skillsAbility to translate complex clinical, operational, and financial data into actionable provider strategiesKnowledge of applicable federal, state, CMS, and contractual requirements governing provider networks and healthcare programsPreferred QualificationsMaster's degree in Healthcare Administration, Business Administration, Public Health, Nursing, or a related fieldExperience with ACO REACH, MSSP, Medicare Advantage, Medicaid, Commercial, and other risk-bearing or value-based arrangementsExperience with clinical documentation improvement and EHR optimization initiativesExperience supporting new market, payer, product, or provider-network implementationsProfessional certification such as CPHQ, CPC, CCS, PMP, Lean Six Sigma, or a similar healthcare or project management credential Environmental Job Requirements and Working Conditions Full-time leadership position supporting provider networks and value-based care initiatives across assigned marketsFrequent use of a computer, telephone, and standard office equipmentAbility to work in a fast-paced environment while managing multiple priorities and strategic initiativesRegular collaboration with providers, executive leadership, health plans, and cross-functional teamsTravel may be required to support provider engagement, market operations, and business needs