Job Description Help for Job Description. Opens a new window. Job Summary Under the general supervision of the Regional Director of Network Management, the Specialist, Provider Relations MSO is responsible for managing and coordinating strategic and operational initiatives that support affiliate provider practices, health plan operations, quality improvement programs, and value-based care initiatives within the MSO environment. This role serves as a liaison between internal departments, affiliate provider offices, health plans, and external vendors to ensure operational efficiency, provider engagement, and successful execution of key projects and initiatives. The Specialist, Provider Relations MSO will lead cross-functional projects related to provider operations, HEDIS performance, data management, credentialing coordination, onboarding processes, and system implementations. The ideal candidate possesses strong healthcare operations knowledge, project management experience, HMO payer familiarity, and the ability to manage multiple priorities while driving process improvements and organizational goals. Essential Duties & Responsibilities
- Lead and manage operational and strategic MSO projects from initiation through implementation and completion.
- Coordinate cross-functional initiatives involving provider relations, credentialing, quality improvement, health plan operations, and data management teams.
- Serve as a primary liaison between affiliate provider offices, internal MSO departments, health plans, and external vendors to ensure project alignment and timely execution.
- Develop project plans, timelines, workflows, and implementation strategies to support organizational objectives.
- Monitor project milestones, deliverables, risks, and dependencies while providing regular status updates to leadership.
- Support provider engagement initiatives and operational improvement strategies across affiliate provider networks.
- Analyze operational workflows and recommend process improvements to increase efficiency, provider satisfaction, and compliance outcomes.
- Assist with the implementation and monitoring of value-based care initiatives, HEDIS performance improvement efforts, and quality metrics.
- Coordinate onboarding activities for new affiliate provider offices, including tracking credentialing progress, system setup, and documentation management.
- Oversee maintenance and accuracy of MSO operational databases, provider directories, SharePoint repositories, and related systems.
- Collaborate with leadership on the preparation and distribution of reports, dashboards, presentations, and project communications.
- Facilitate meetings with affiliate providers, health plans, vendors, and internal stakeholders to support project execution and issue resolution.
- Track and monitor provider-related operational metrics, identifying trends and recommending corrective actions when needed.
- Assist with rollout and implementation of operational tools, system enhancements, workflows, and training materials.
- Ensure compliance with organizational standards, health plan requirements, and regulatory guidelines.
- Maintain project documentation, meeting minutes, implementation records, and operational procedures. Supervisory Responsibilities
- No supervisory responsibilities