Provider Relations Specialist

At Umpqua Health, we're more than just a healthcare organization; we're a community-driven Coordinated Care Organization (CCO) committed to improving the health and well-being of individuals and families throughout our region. Our comprehensive services include primary care, specialty care, behavioral health services, and care coordination to ensure our members receive holistic, integrated healthcare. Our collaborative approach fosters a supportive environment where every team member plays a vital role in our mission to provide accessible, high-quality healthcare services. From preventative care to managing chronic conditions, we're dedicated to empowering healthier lives and building a stronger, healthier community together.

Umpqua Health strongly encourages applications from candidates of color as well as veterans, aiming to foster a work environment that is linguistically and culturally diverse and inclusive. Please note that at this time, Umpqua Health does not offer visa sponsorship.

The Provider Relations Specialist plays a multifaceted role in fostering positive relationships between our organization and healthcare providers. This position involves conducting secret shopper calls, monitoring service access, gathering data for quality assurance measures, gathering data, and performing administrative duties. The Specialist must possess a combination of strong interpersonal skills, analytical abilities, and organizational proficiency to excel in this role. The Provider Relations Specialist plays a crucial role in ensuring the success of our organization by fostering strong relationships with healthcare providers, monitoring service quality, conducting secret shopper calls, and gathering data to support quality assurance measures. This position requires a proactive and detail-oriented individual with a passion for improving healthcare delivery and outcomes. 

• Gather from our vendor and conduct secret shopper calls to evaluate provider performance, customer service, and adherence to service standards.
• Document findings accurately and provide actionable feedback to improve provider-patient interactions.
• Gather metrics and performance indicators to assess the quality of services provided by healthcare providers.
• Conduct regular audits and reviews to identify areas for improvement and ensure compliance with contractual agreements and regulatory standards.
• Collaborate with providers to address any issues or concerns related to service quality and adherence to guidelines.
• Gather and analyze data related to provider performance, patient satisfaction, and service outcomes.
• Compile reports and presentations to communicate findings and recommend strategies for improvement.
• Utilize healthcare management software and databases to maintain accurate records and track performance metrics.
• Work with department to support the development and implementation of training programs to educate providers on our organization's services, protocols, and standards.
• Collaborate with internal departments to ensure training materials are accurate, up-to-date, and aligned with regulatory requirements.
• Work with department to support training sessions, webinars, and workshops to disseminate information and address provider inquiries.
• Assist in administrative tasks such as scheduling meetings, maintaining calendars, and coordinating logistics for events or training sessions.
• Prepare and organize documentation, reports, and presentations for internal and external stakeholders.
• Serve as a liaison between providers and internal departments to facilitate communication and address administrative needs.
• Perform other duties as assigned by management needed to help drive to our Vision, fulfill our Mission, and abide by our Organization’s Values.

• Bachelor's degree in Healthcare Administration, Business Administration, or related field or equivalent experience
• Minimum of 3 years of experience in provider relations, healthcare administration, or a related field.
• Strong understanding of healthcare operations, regulations, and industry trends.
• Excellent communication, negotiation, and interpersonal skills.
• Analytical mindset with the ability to interpret data and identify trends.
• Proficiency in Microsoft Office Suite and healthcare management software.
• Experience in conducting secret shopper calls and quality assurance monitoring preferred.
• Ability to manage multiple tasks, prioritize responsibilities, and meet deadlines.

Umpqua Health is an equal opportunity employer that embraces individuals from all backgrounds. We prohibit discrimination and harassment of any kind, ensuring that all employment decisions are based on qualifications, merit, and the needs of the business. Our dedication to fairness and equality extends to all aspects of employment, including hiring, training, promotion, and compensation, without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, veteran status, or any other protected category under federal, state, or local law.