Provider Relations Specialist - Suffolk Country

HealthCare Partners, IPA and HealthCare Partners, MSO together comprise our health care delivery system providing enhanced quality care to our members, providers and health plan partners. Active since 1996, HealthCare Partners (HCP) is the largest physician-owned and led IPA in the Northeast, serving the five boroughs and Long Island. Our network includes over 6,000 primary care physicians and specialists delivering services to our 125,000 members enrolled in Commercial, Medicare and Medicaid products. Our MSO employs 200+ skilled professionals dedicated to ensuring members have access to the highest quality of care while efficiently utilizing healthcare resources.

HCP’s vision is to be recognized by members, providers and payers as the organization that delivers unsurpassed excellence in healthcare to the people of New York and their communities. We pride ourselves on selecting the most qualified candidates who reflect HCP’s mission of serving our members by facilitating the delivery of quality care. Interested in joining our successful Garden City Team? We are currently seeking a Provider Relations Specialist for our Suffolk country territory!

Position Summary: HealthCare Partners (HCP) is dedicated to improving our healthcare ecosystem. The Provider Relations Specialist is the mission-critical linchpin between HealthCare Partners and our network of primary care physicians. This role focuses on fostering strong working relationships with PCPs and staff in an ongoing effort to advance HCP’s organizational objectives, facilitate value based care, and improve both provider satisfaction and member health. The Provider Relations Specialist leverages data and knowledge of the primary care setting to identify PCP opportunities and tailor strategic action plans to support success. The Provider Relations Specialist serves as an internal subject matter expert with regard to their territory and collaborates cross departmentally to engage physicians optimally. This unique role blends a service and consultative approach to ensure HCP achieves its mission.
Essential Position Functions/Responsibilities:

• Establish and maintain collaborative relationships with PCPs and their staff through regular touchpoints, acting as the primary liaison between HCP and the provider network.
• Educate providers on HCP’s value-based care model, ensuring alignment with organizational goals and objectives.
• Proactively identify and address provider concerns, leveraging data and analytics to tailor strategic action plans.
• Serve as a point of contact on provider relations, offering guidance to internal teams and stakeholders.
• Provide strategic insights and recommendations to providers on optimizing performance in key metrics such as HEDIS, HCC, and STAR ratings.
• Collaborate with cross-functional teams—including Quality, Risk Adjustment, and Care Management—to drive performance improvement and ensure seamless provider support.
• Continuously evaluate processes and recommend improvements to enhance provider relations and streamline operational workflows.
• Maintain up-to-date knowledge of industry regulations, trends, and payer policies to provide informed guidance to providers.

Qualification Requirements:
Skills, Knowledge, Abilities

• Strong desire and ability for creative problem solving and customer centric focus.
• Strong customer service and “soft-skills.” Ability to interface with physicians and staff in a positive and professional manner to create alignment and achieve common goals.
• Strong knowledge of primary care office operations and managed care models preferred.
• General understanding of HCC, Stars, HEDIS and their role in physician reimbursement/ incentives preferred.
• Proven ability to manage multiple projects simultaneously.
• Ability to work well independently.
• Ability to work well in groups.
• Excellent oral and written communication/ presentation skills.
• Proficiency in Microsoft Outlook, Excel, Word and PowerPoint.
• Valid Driver’s License and Motor Vehicle Insurance.

Training/Education:

• Bachelor’s degree in healthcare, business administration or equivalent working field experience, required.
• Non-Bachelor’s degree in clinical discipline considered.

Experience:

• Two or more years’ experience in HMO, IPA or medical group, Physician Management Company, or other managed care organization.
• Consulting or Account Management experience considered.

Base Compensation; $65,000 - $75,000 annually
Bonus Incentive: Up to 5% of base salary

HealthCare Partners, MSO provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, HealthCare Partners, MSO complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.