Provider Relations Specialist V - Provider Services

The ideal candidate is a strategic leader with experience in healthcare delivery, managed care operations, customer relationship management, and provider relations. They have demonstrated leadership experience and a proven ability to build strong provider partnerships, improve provider satisfaction, and ensure regulatory and contractual compliance. This individual excels at collaborating with cross-functional stakeholders, driving process improvements, analyzing provider and market data, and implementing solutions that improve access to care and operational performance.

Strong communication, relationship-building, project management, and problem-solving skills are essential, along with the ability to influence stakeholders and lead complex initiatives that support organizational and provider network success.

Note:

Work location is on-site with the flexibility to work remotely, the primary location will be in-office for meetings, per Kaiser Permanente-s Authorized States Policy - Employees may be required to travel to a Kaiser Permanente or customer site. Residency required in the primary location: 9 Piedmont Center, 3495 Piedmont Rd., NE, Atlanta, Georgia 30305

In addition to the responsibilities listed below, this position is also responsible for leading the planning, development, and implementation of provider satisfaction strategies to improve network relationships and enhance provider engagement; overseeing the development of provider relations programs to facilitate effective provider communications and problem resolution; and creating and distributing media materials (e.g., articles and newsletters), publications, and manual updates to providers;

ensuring providers adhere to regulatory and contractual requirements; leading the escalation of complex compliance issues to appropriate parties; supporting organizational responses to regulatory audits; and leading the delivery of provider education and/or onboarding.

• Promotes learning in others by communicating information and providing advice to drive projects forward; builds relationships with cross-functional stakeholders. Listens, responds to, seeks, and addresses performance feedback; provides actionable feedback to others, including upward feedback to leadership and mentors junior team members. Practices self-leadership; creates and executes plans to capitalize on strengths and improve opportunity areas; influences team members within assigned team or unit.
  
  Adapts to competing demands and new responsibilities; adapts to and learns from change, challenges, and feedback. Models team collaboration within and across teams.
• Conducts or oversees business-specific projects by applying deep expertise in subject area; promotes adherence to all procedures and policies. Partners internally and externally to make effective business decisions; determines and carries out processes and methodologies; solves complex problems; escalates high-priority issues or risks, as appropriate; monitors progress and results. Develops work plans to meet business priorities and deadlines; coordinates and delegates resources to accomplish organizational goals.
  
  Recognizes and capitalizes on improvement opportunities; evaluates recommendations made; influences the completion of project tasks by others.
• Supports continuous improvement efforts by: leveraging innovative and data-driven approaches to identify and/or consult on continuous improvement opportunities across the contract ecosystem (e.g., identifying business and operational disparities between organizational and provider expectations, constraints, and risks to accessible care, building and maintaining relationships); driving the implementation of process improvement initiatives to aid providers and business goals; collaborating with internal and external partners to develop network strategies and implement improved access to care;
  
  and may also include conducting and/or collaborating in complex modeling and analyses of provider and market data to develop recommendations, solutions, and action plans for improvement initiatives.
• Ensures contract commitments are met by: validating, maintaining, and/or conducting statistical analyses on provider and contract data of the day-to-day operation and management of services to identify trends and consult on provider compliance; documenting and reporting provider activities and/or coordinating with alternate stakeholders to ensure compliance with contract terms and…