Provider Network Manager - Florida

Description

Astrana is seeking a Provider Network Manager to be responsible for building and maintaining strong provider relationships to support engagement, satisfaction, compliance, and performance in the Accountable Care Organization (ACO).

This position independently manages complex, cross-functional projects and exercises sound judgment in evaluating performance and recommending strategies that impact value-based care outcomes. The Manager will be responsible for analyzing practice performance and executing strategies to improve and optimize ACO performance across Florida and emerging markets. The role identifies practice-specific opportunities, translates data into actionable strategies, and drives ACO initiatives aligned with organizational and market objectives.

Reporting to the Senior Director of Operations, the Manager serves as a strategic partner to internal stakeholders and external providers, integrating data analysis, provider engagement, and operational execution to drive sustainable performance improvement and alignment with regulatory and value-based care requirements.

Our Values:

• Put Patients First
• Empower Entrepreneurial Provider and Care Teams
• Operate with Integrity & Excellence
• Be Innovative
• Work As One Team

What You’ll Do

• Serve as a primary point of contact for ACO providers, guiding them through recruitment, onboarding, education and process improvement processes.
• Conduct in-person and virtual meetings with physicians, provider groups, and staff members to present practice specific improvement opportunities and influence decisions and actions.
• Identify and recommend improvements to provider engagement strategies and onboarding experiences.
• Build and maintain relationships with key provider stakeholders to support long-term ACO success.
• Monitor overall provider performance utilizing performance data and insights (i.e., quality, utilization, referral management, risk), provider engagement activities, and team feedback.
• Understand, support HCC improvement activities with assigned practices, in collaboration with Astrana’s coding team.
• Implement provider change management activities at the practice and market level: organize and structure provide education sessions, develop tools with their team to establish provider profiles and insights to identify key areas in the workflow that can improve to better align in office activities such as AWV workflow and scheduling processes.
• Serve as a liaison among Value-Based Care, Business Development, Operations, Quality, and other internal teams to facilitate alignment and effective execution.
• Provide data-driven insights and recommendations to leadership to inform practice- and market-level operational improvements.
• Serve as a subject matter expert on Market Representative activities that support ACO performance, identifying and sharing best practices across markets.
• Partner with leadership to align performance improvement initiatives with broader ACO and organizational objectives.
• Other duties as assigned.

Qualifications

• Bachelor’s degree in Healthcare Administration, Business, Finance, or related field required
• At least 5 years of experience in provider network relations, healthcare operations, managed care, or related field
• Experience in provider relations and ACO experience preferred
• Demonstrated experience analyzing data and making recommendations that impact business or operational outcomes
• Valid driver’s license with ability to travel within the Florida service area and occasionally to the West coast
• Demonstrated ability to exercise independent judgment and discretion in evaluating provider opportunities for ACO performance improvement
• Strong analytical skills with the ability to interpret data and translate findings into actionable strategies
• Understanding of value-based care and be able to bridge the gap in provider understanding of the concepts
• Knowledge of CMS, Medicare, and ACO regulatory requirements
• Ability to influence stakeholders and build relationships with providers and internal partners.
• Strong communication and presentation skills
• Ability to manage multiple priorities and adapt in a fast-paced environment
• Proficiency in Microsoft Office and data/reporting tools

Environmental Job Requirements and Working Conditions

• This is a full-time, remote position with regular travel and field-work requ…