Director, Provider Relations

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Full Time Senior Management Miami, FL, US

We are seeking a Director, Provider Relations to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.

About the Role:

The Director, Provider Relations plays a pivotal role in establishing and maintaining strong, collaborative partnerships with healthcare providers. The Director, Provider Relations position is responsible for developing strategic initiatives that enhance provider engagement, satisfaction, and network growth to support organizational goals. The Director, Provider Relations requires overseeing contract negotiations, resolving provider issues, and ensuring compliance with regulatory standards to optimize service delivery.

The Director, Provider Relations will lead a team dedicated to fostering transparent communication and continuous improvement in provider relationships. Ultimately, the Director, Provider Relations drives the alignment of provider networks with the company’s mission to deliver high-quality, accessible healthcare services.

Minimum Qualifications:

• Bachelor’s degree in Healthcare Administration, Business, or a related fieldor 8+ years of directly equivalent experience.
• Minimum of 5+ years of experience in provider relations, network management, or healthcare administration.
• Proven experience in contract negotiation and management within the healthcare industry.
• Strong knowledge of healthcare regulations, payer-provider dynamics, and network development.
• Demonstrated leadership skills with experience managing teams and driving strategic initiatives.

Preferred Qualifications:

• Master’s degree in Healthcare Administration, Business Administration, or a related discipline.
• Experience working with managed care organizations or health insurance providers.
• Familiarity with healthcare data analytics and performance measurement tools.
• Certification in healthcare management or related professional credentials.
• Experience leading provider relations in a multi-state or national healthcare organization.

Responsibilities:

• Develop and implement comprehensive provider relations strategies to strengthen partnerships and expand the provider network.
• Lead contract negotiations and renewals with healthcare providers, ensuring favorable terms and compliance with regulatory requirements.
• Manage and resolve provider inquiries, disputes, and performance issues promptly to maintain positive relationships.
• Collaborate with cross-functional teams including network management, compliance, and operations to align provider relations initiatives with organizational objectives.
• Monitor provider satisfaction metrics and implement continuous improvement plans based on feedback and industry best practices.
• Oversee the training and development of the provider relations team to enhance their effectiveness and professional growth.
• Stay informed on healthcare industry trends, regulations, and competitive landscape to proactively address challenges and opportunities.
• Lead team of Account Executives aligned to accomplish the above