Sr Provider Relations Liaison

Senior Provider Relations Account Manager

The Senior Provider Relations Specialist is responsible for building, maintaining and strengthening relationships with the Commonwealth Care Alliance's (CCA) diverse provider community including physician, hospital, behavioral health, community-based, LTSS, and HCBS providers. This individual serves as a key liaison, proactively addressing provider needs, ensuring regulatory compliance, and supporting operational excellence to enhance provider satisfaction and member access to care.

Reporting to the Senior Director of Delegation Partnerships, the Senior Provider Relations Account Manager will :

• Lead provider servicing activities, including onboarding, orientation presentations, and ongoing education initiatives.
• Serve as a primary resource for resolving provider inquiries and supporting issue resolution.
• Collaborate in the implementation of CCA's enterprise-wide provider engagement strategy, focused on delivering a best-in-class provider experience.
• Utilize strategic planning and data-driven insights to identify opportunities for continuous improvement in provider relations and organizational performance.

By fostering strong partnerships and supporting process enhancements, the Senior Provider Relations Account Manager plays a vital role in helping CCA achieve its mission and goals within the provider community.

No, this position does not have direct reports.

Essential Duties & Responsibilities :

Develop strong professional relationships with providers across all specialties physician, hospital, behavioral health, community based, and ancillary providers and their staff.

Facilitate and lead communication sessions, educating on CCA's policies, program benefits, billing, referral and authorizations regulatory compliance, and contractual expectations. Conduct orientation and ongoing education (virtual and in-person) for new and existing providers.

Collaborate with cross-functional teams (e.g., Claims, Credentialing, Clinical Care Management, Member Services, Provider Services, Regulatory Affairs, Marketing) to resolve provider issues and reduce administrative burden.

Working Conditions :

Required Education (must have) :

Required Experience (must have) :

Required Knowledge, Skills & Abilities (must have) :

Valid Driver's license and reliable insured automobile required

Required Language (must have) :