SENIOR PROVIDER PRACTICE COACH
About The Position
The Senior Provider Practice Coach leads provider performance improvement and practice transformation initiatives. The role partners in person and remotely with provider practices, Practice Support Advisors, and internal subject-matter experts to identify performance barriers, develop targeted improvement strategies, redesign workflows, and support sustainable improvements in quality, operational performance, and provider engagement. The position serves as an advanced resource for complex or underperforming practices, providing guidance, facilitation, and coordination across operational areas. It collaborates with Quality, Risk Adjustment, Clinical, Claims, Utilization Management, Credentialing, Contracting, Compliance, and other departments; functional ownership, decision-making authority, and accountability remain with those respective departments. The role may travel up to 50% of the time in the greater Sacramento Area and operates in a professional office environment.
Requirements
- Experience in provider relations, managed care, practice transformation, quality improvement, population health, or healthcare operations.
- Working knowledge of HEDIS and quality programs, claims, utilization management, authorizations, credentialing, contracting, compliance, and managed-care operations.
- Ability to analyze performance data, identify improvement opportunities, and facilitate initiatives that support measurable outcomes.
- Strong communication, presentation, facilitation, active-listening, relationship-management, and interpersonal skills, including the ability to engage providers, members, and internal stakeholders.
- Strong critical-thinking, analytical, and problem-solving skills, including the ability to independently resolve moderately complex issues with minimal supervision.
- Leadership, initiative, and accountability, including the ability to collaborate across departments and influence outcomes without direct authority.
- Ability to establish and maintain effective professional relationships while demonstrating professionalism, confidence, sound judgment, and sincerity.
- Strong organizational, planning, time-management, and follow-through skills, including the ability to manage multiple priorities and competing deadlines in a dynamic, fast-paced environment.
- Ability to work independently and collaboratively within a team to achieve departmental and organizational objectives.
- Ability to provide and receive constructive, job- and industry-related feedback professionally.
- Ability to exercise sound discretion, maintain confidentiality, and handle and disclose sensitive information appropriately on a need-to-know basis.
- Commitment to excellent customer service and professional representation of the company.
- Attention to detail and ability to maintain accurate, complete, and timely documentation.
- Commitment to the organization's mission, values, and service standards.
- Intermediate proficiency in Microsoft Word, Excel, PowerPoint, Visio, and email applications.
- Ability to learn and effectively use new software, technology, and healthcare-related systems.
- High school diploma or GED minimum.
- Active and unrestricted driver's license.
Nice To Haves
- Bachelor's degree in healthcare administration, business, public health, nursing, or a related field; equivalent relevant experience may be considered.
- Typing speed of 40 words per minute or greater.
Responsibilities
- Lead practice transformation and performance improvement initiatives for complex or high-priority provider practices.
- Analyze provider performance information and identify barriers, trends, and opportunities for improvement.
- Develop and support implementation of provider performance improvement plans and workflow changes.
- Partner with Quality and other subject-matter experts to support HEDIS, Stars, care-gap closure, risk adjustment, and organizational performance initiatives.
- Facilitate root-cause analysis and recommend sustainable solutions to recurring operational and performance issues.
- Provide advanced education and coaching to providers, practice leadership, and office staff.
- Coordinate resolution of complex issues involving claims, authorizations, referrals, utilization management, credentialing, contracting, compliance, grievances, and related provider operations.
- Serve as a resource and mentor to Practice Support Advisors.
- Identify systemic provider barriers and collaborate with internal departments on improvement opportunities.
- Maintain appropriate documentation of provider improvement activities, outcomes, and follow-up.
- Perform related duties consistent with the scope and intent of the position, including regular attendance and travel as required.
- Enforce company policies and safety procedures.
- Update job knowledge through educational opportunities, professional publications, professional networks, and professional organizations.
- Maintain IPA and Health Plan compliance standards.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
High school or GED
