Provider Relations Supervisor (Org Wide)

Lakeland Care•Fond du Lac, WI

1d•Remote

About The Position

Under the supervision of the Provider Relations Manager, the Provider Relations Supervisor is responsible for building and maintaining strong partnerships with new and existing service providers, community agencies, and representatives. This ensures Lakeland Care, Inc. (LCI) maintains a diverse, high-quality provider network for its members. Key responsibilities include: Lead and develop provider relations staff by providing supervision, coaching, accountability, performance management, and consistent guidance to ensure department goals and standards are met. Maintain a strong, compliant provider network through oversight of provider functions and adherence to state, federal, and contractual requirements. Serve as key operational and relationship leader by building partnerships with providers, resolving escalated issues, supporting negotiations, and representing LCI with providers, community partners, and internal teams. Use data and business insights to drive decision-making and improvements by monitoring utilization trends, evaluating provider performance and network needs, supporting rate methodologies, and identifying opportunities to improve processes and outcomes. The Provider Relations Supervisor also plays a critical role in fostering an environment where LCI providers can thrive by encouraging innovation and cost-effective service delivery. This role supports both external providers and internal stakeholders to ensure timely access to necessary provider resources. Additionally, the position is responsible for accountability, follow through, and critical thinking. This statewide role requires close collaboration with the Provider Relations Supervisors, Care Management, and Provider Relations Managers to ensure consistency in communication and practices among Provider Network staff across LCI’s service regions.

Requirements

Bachelor’s degree in Accounting, Business, Social Work, Healthcare Administration, or a related field, or an equivalent combination of education and experience (including knowledge, skills, and abilities).
Minimum of three (3) years of leadership experience in healthcare, long-term care, or the health insurance industry.
Two (2) to four (4) years of experience in contract negotiation supporting purchaser-provider business relationships, preferably in long-term care or acute and primary healthcare.
Proficiency in analyzing healthcare financial and utilization data.
Understanding of the service provider industry, subcontracting, licensing, regulatory systems, and provider network contracting in a managed care model is preferred.
Familiarity with federal and state rules and regulations governing Medicaid and Medicaid waiver programs.
Demonstrated knowledge of managed care principles.
Strong ability to interpret business documents, contractual and regulatory language, and convey information clearly and professionally through both written and verbal communication.
Capability to work under time constraints while maintaining attention to detail.
Ability to respond effectively to sensitive inquiries and situations.
Proven ability to communicate with various segments of the general population and the professional community.
Excellent verbal and strong written communication skills are required.
Outstanding organizational skills with the ability to manage multiple responsibilities.
A current driver’s license, an acceptable driving record, and proof of adequate insurance are required.

Nice To Haves

Experience, training, or skills in mediation and negotiations, analyzing and interpreting data for strategic planning and system implementation, and delivering training and presentations to groups.

Responsibilities

Lead and develop provider relations staff by providing supervision, coaching, accountability, performance management, and consistent guidance to ensure department goals and standards are met.
Maintain a strong, compliant provider network through oversight of provider functions and adherence to state, federal, and contractual requirements.
Serve as key operational and relationship leader by building partnerships with providers, resolving escalated issues, supporting negotiations, and representing LCI with providers, community partners, and internal teams.
Use data and business insights to drive decision-making and improvements by monitoring utilization trends, evaluating provider performance and network needs, supporting rate methodologies, and identifying opportunities to improve processes and outcomes.
Foster an environment where LCI providers can thrive by encouraging innovation and cost-effective service delivery.
Support both external providers and internal stakeholders to ensure timely access to necessary provider resources.
Recruit and onboard new providers, particularly those enhancing community integration opportunities for members, while promoting expansion within the existing provider network.
Maintain and update the Provider Directory, overseeing service code reviews and updates as needed.
Ensure strong provider relationships by monitoring service trends, rate methodologies, and utilization data to support strategic decision-making.
Supervise the Provider Specialist teams, ensuring adherence to standard operating practices, procedures, and policy.
Provide leadership that reflects LCI’s mission, vision, and values, fostering a success-oriented and accountable work environment.
Solve problems with a member-centered, values based, outcome-driven, and solution-focused approach.
Support Lakeland Care’s Strategic Plan by ensuring provider relations align with organizational goals and network adequacy requirements.
Demonstrate expertise in service provider contracts, regulatory requirements, the DHS Family Care Contract, service rates, and the impact of contracting decisions.
Establish performance standards, provide clear direction, hold staff accountable, and foster professional development through regular feedback and support.
Provide ongoing updates and data analysis to the Provider Relations Manager and the Provider Relations Senior Manager on service trends, network adequacy, and process improvements.
Model accountability through sound decision-making, professional communication, responsiveness, and reliable follow-through.
Lead and manage high-impact projects from planning through implementation, coordinating stakeholders, delegating responsibilities, managing timelines, and ensuring successful outcomes.
Ensure decisions, actions, and follow-up activities are appropriately communicated, documented, and completed.
Analyze complex situations, identify root causes, evaluate available information, and develop practical solutions that align with organizational goals and regulatory requirements.
Exercise sound judgment in prioritizing work, allocating resources, and making decisions that balance member needs, provider needs, operational requirements, and organizational risk.
Anticipate potential issues and emerging trends by reviewing data, monitoring outcomes, and recognizing patterns that may require intervention or process improvement.
Evaluate the impact of decisions on members, providers, staff, compliance, finances, and organizational operations before determining a course of action.
Navigate ambiguity by gathering relevant information, consulting appropriate resources, and making timely decisions when complete information may not be available.
Challenge existing processes and assumptions constructively, identifying opportunities to improve efficiency, effectiveness, quality, and service delivery.
Support staff in developing critical thinking and problem-solving skills through coaching, guidance, and discussion that encourages independent analysis and decision-making.
Identify and implement process improvements and corrective actions based on data analysis, operational experience, audit findings, stakeholder feedback, and observed trends.
Demonstrate a commitment to excellence by maintaining high standards for quality, accuracy, timeliness, and customer service in all aspects of work.
Foster a culture of continuous improvement by identifying opportunities to enhance processes, eliminate inefficiencies, and improve outcomes for members, providers, and the organization.
Monitor team performance and work quality, providing coaching and support to promote consistent adherence to established standards and best practices.
Encourage innovation, learning, and professional development to strengthen team capabilities and support organizational goals.
Lead by example through professionalism, responsiveness, adaptability, and a commitment to delivering exceptional results.
Seek and incorporate feedback, data, audit findings, and stakeholder input to improve performance, service delivery, and operational effectiveness.
Promote consistency and standardization across processes while remaining open to new approaches that improve quality or efficiency.
Demonstrate organizational values and actively contribute to initiatives that advance quality, compliance, member experience, provider experience, and operational excellence.
Develop, write and maintain SOPs, workflows, tools, and other operational resources that support staff effectiveness, streamline processes, promote consistency, and drive continuous improvement.
Demonstrate professionalism and sound judgment when addressing challenges and making high-impact decisions.
Maintain professionalism by demonstrating appropriate emotional responses and performing effectively under pressure.
Approach demanding situations constructively, resolve conflicts appropriately, and foster a positive work environment.
Communicate openly and transparently with LCI contracted providers and internal teams to enhance organizational practices.
Respect diverse perspectives, opinions, and concerns, valuing inclusivity in thought and action.
Act with honesty, trust, and integrity in all interactions.
Be receptive to feedback and continuously seek opportunities for growth and improvement.
Motivate and lead a high-performing team by attracting, recruiting, mentoring, and professionally developing employees.
Delegate responsibilities to foster employee growth and contribute to the success of Lakeland Care.
Actively mentor and develop leadership internally while supporting leadership growth among providers and key stakeholders.
Influence others through positive reinforcement, teamwork, and expertise in provider relations.
Establish and maintain strong relationships with service providers, community organizations, and stakeholders.
Conduct regularly scheduled provider meetings and assist in coordinating residential and non-residential provider forums to educate on agency procedures, service delivery, and contract standards.
Attend community and networking events, as well as conferences, to recruit new providers.
Oversee new provider inquiries and initiate outreach to expand the network.
Assist in creating provider communications, including the Provider Handbook, newsletters, and Provider Network Advisory Committee materials.
Coordinate activities with both network and non-network providers to ensure service availability and the inclusion of natural community resources within the network.
Foster strong interdepartmental relationships and maintain frequent collaboration across divisions.
Lead and actively participate in strategic initiatives that drive performance excellence while modeling Lakeland Care’s (LCI) Mission, Vision, and Core Values.
Foster strong interdivisional collaboration, particularly with Utilization and Care Management divisions, to address member needs, interpret data, and implement action plans.
Provide internal education and support on contracts, addendums, provider resources, and enhance understanding of provider expertise.
Promote continuous improvement by evaluating systems, providing honest and timely feedback, and supporting organizational change.
Organize, facilitate, and contribute to LCI stakeholder and provider meetings/forums, while representing LCI at professional events both internally and externally.
Collaborate with IDT staff, attending meetings as needed to discuss provider updates and issues, educate on contracts and provider resources, and strengthen provider partnerships.
Demonstrate LCI’s core values of Kindness, Inclusion, and Trust in all interactions and initiatives.