Market Provider Relations Specialist - Houston 1
About The Position
Astrana Health is seeking a highly motivated Market Provider Relations Specialist to support its IPA Operations and Provider Relations team. This field-based role serves as the primary liaison between Astrana Health and assigned provider practices, supporting provider engagement, practice transformation, quality improvement, risk adjustment performance, utilization management, and value-based care initiatives. The specialist partners with physicians, practice leadership, and care teams to identify operational and clinical improvement opportunities, implement value-based care strategies, and help achieve organizational performance goals. Through provider education, performance analysis, workflow optimization, and relationship management, the role helps practices improve patient outcomes, documentation accuracy, operational effectiveness, and financial performance. The position follows a hybrid work structure, with work in the office and remotely on a weekly basis. Regular travel throughout the assigned market to provider offices, clinics, and community locations may be required, as may attendance at provider meetings, trainings, and market events. The target pay range is $75,000–$85,000 per year; actual compensation depends on factors including location, experience, qualifications, and internal equity.
Requirements
- Bachelor's degree in Healthcare Administration, Public Health, Nursing, Business Administration, or a related field preferred, or an equivalent combination of education and relevant healthcare experience.
- At least three years of experience in provider relations, healthcare operations, managed care, practice management, quality improvement, population health, risk adjustment, or a related healthcare field.
- Knowledge of provider office operations and healthcare delivery models.
- Working knowledge of HEDIS, CMS Star Ratings, quality improvement, and risk adjustment principles.
- Strong analytical skills and ability to interpret provider performance data and translate findings into actionable recommendations.
- Strong relationship-building, communication, presentation, and facilitation skills.
- Strong organizational and project management abilities, including ability to manage multiple priorities and deadlines.
- Proficiency with Microsoft Office applications and reporting tools.
Nice To Haves
- Experience working directly with physician practices.
- Experience supporting value-based care programs.
- Understanding of managed care, Medicare Advantage, ACOs, IPA operations, or population health programs.
- Experience supporting provider performance improvement initiatives.
- Experience within Medicare Advantage, Medicaid, ACO, IPA, or other value-based care models.
- Experience with provider education, workflow optimization, and practice transformation initiatives.
- Familiarity with utilization management, population health, and care coordination programs.
Responsibilities
- Serve as the primary point of contact for assigned provider practices and build relationships with physicians, office managers, practice administrators, and clinical staff.
- Conduct provider meetings and site visits to review performance, discuss initiatives, address challenges, and support improvement efforts.
- Support provider engagement, practice transformation, quality improvement, risk adjustment, utilization management, and value-based care initiatives.
- Educate providers and practice staff on HEDIS, CMS Star Ratings, risk adjustment, documentation requirements, population health, and quality improvement programs.
- Review provider performance reports and scorecards, identify improvement opportunities, and assist with developing action plans.
- Support providers in improving documentation accuracy, coding practices, care gap closure, chronic disease management, and patient outcomes.
- Assist with operational questions related to claims, referrals, authorizations, credentialing, provider data, and other provider service functions.
- Partner with Quality, Risk Adjustment, Care Management, Medical Management, Claims, Contracting, Credentialing, and Operations teams to support provider success.
- Monitor provider engagement activities, maintain accurate documentation, and provide updates on market and provider performance.
- Support implementation of new programs, payer initiatives, regulatory requirements, and organizational priorities.
- Attend provider meetings, trainings, and market events as needed.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
