SENIOR PROVIDER PRACTICE COACH (3628)

Job Summary:

The Senior Provider Practice Coach is responsible for leading provider performance improvement and practice transformation initiatives. This position partners frequently, both in person and remotely, with provider practices, Practice Support Advisors, and internal subject-matter experts to identify performance barriers, develop targeted improvement strategies, redesign workflows, and support sustainable improvements in quality, operational performance, and provider engagement.

The Senior Provider Practice Coach serves as an advanced resource for complex and underperforming practices, providing guidance, facilitation, and coordination across multiple operational areas. The position works collaboratively with Quality, Risk Adjustment, Clinical, Claims, Utilization Management, Credentialing, Contracting, Compliance, and other operational departments, while functional ownership, decision-making authority, and accountability remain with the respective departments.

Responsibilities:

• Lead practice transformation and performance improvement initiatives for complex or high-priority provider practices.
• Analyze provider performance information and identify barriers, trends, and opportunities for improvement.
• Develop and support implementation of provider performance improvement plans and workflow changes.
• Partner with Quality and other subject-matter experts to support HEDIS, Stars, care-gap closure, risk adjustment, and organizational performance initiatives.
• Facilitate root-cause analysis and recommend sustainable solutions to recurring operational and performance issues.
• Provide advanced education and coaching to providers, practice leadership, and office staff.
• Coordinate resolution of complex issues involving claims, authorizations, referrals, utilization management, credentialing, contracting, compliance, grievances, and related provider operations.
• Serve as a resource and mentor to Practice Support Advisors.
• Identify systemic provider barriers and collaborate with internal departments on improvement opportunities.
• Maintain appropriate documentation of provider improvement activities, outcomes, and follow-up.

• Performs related duties consistent with the scope and intent of the position.
• Regular attendance.
• Travel as required.

Other Functions

• Enforces Company policies and safety procedures.
• Regularly updates job knowledge by participating in educational opportunities, reading professional publications, maintaining professional networks, and participating in professional organizations.
• Maintain IPA, Health Plan compliance standards.

Travel

• The incumbent may travel up to 50% of the time in the greater Sacramento Area.

Work Environment

This job operates in a professional office environment.  This role routinely uses office equipment such as computers, phones, photocopiers, scanners and filing cabinets.

Competencies

• Experience in provider relations, managed care, practice transformation, quality improvement, population health, or healthcare operations. 
• Working knowledge of HEDIS and quality programs, claims, utilization management, authorizations, credentialing, contracting, compliance, and managed-care operations. 
• Demonstrated ability to analyze performance data, identify opportunities for improvement, and facilitate initiatives that support measurable outcomes. 
• Strong communication, presentation, facilitation, active-listening, relationship-management, and interpersonal skills, with the ability to effectively engage providers, members, and internal stakeholders. 
• Strong critical-thinking, analytical, and problem-solving skills, with the ability to independently resolve moderately complex issues with minimal supervision. 
• Demonstrated leadership, initiative, and accountability, including the ability to collaborate across departments and influence outcomes without direct authority. 
• Ability to establish and maintain effective professional relationships while demonstrating professionalism, confidence, sound judgment, and sincerity. 
• Strong organizational, planning, time-management, and follow-through skills, with the ability to manage multiple priorities and meet competing deadlines in a dynamic, fast-paced environment. 
• Ability to work effectively both independently and collaboratively within a team environment to achieve departmental and organizational objectives. 
• Ability to provide and receive constructive, job- and industry-related feedback professionally. 
• Ability to exercise sound discretion, maintain confidentiality, and appropriately handle and disclose sensitive information on a need-to-know basis. 
• Demonstrated commitment to consistently delivering excellent customer service and representing the Company in a professional manner. 
• Excellent attention to detail, with the ability to maintain accurate, complete, and timely documentation. 
• Demonstrated commitment to the organization’s mission, values, and service standards. 
• Intermediate proficiency in Microsoft Word, Excel, PowerPoint, Visio, and email applications.
• Ability to quickly learn and effectively use new software, technology, and healthcare-related systems. 
• Typing speed of 40 words per minute or greater is preferred.

Education and Licensure

• High School Diploma or GED minimum.
• Bachelor's degree in healthcare administration, business, public health, nursing, or a related field preferred; equivalent relevant experience may be considered.
• Active and unrestricted Driver’s License.

Salary : $85,000 - $95,000