Provider Relations Supervisor; Org Wide

Description

Join our award winning culture as we serve members in your area!

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.

Essential Competencies:

• 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,…