Senior Manager, Provider Relations and Performance Management

Salary Range: $135,136.00 (Min.) - $175,676.00 (Mid.) - $216,218.00 (Max.)

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.

Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.

Job Summary

4 Positions Available

The Senior Manager, Provider Relations and Performance Management drives organizational excellence by fostering strategic provider engagement and robust performance oversight. This role ensures providers operate within a framework of clear accountability, structured engagement, and actionable performance information, while proactively addressing operational concerns and upholding contractual obligations.

Key responsibilities include developing tailored account management strategies, leading structured joint operating and performance review meetings, and delivering differentiated provider experience focused on operational processes and relationship priorities. The role establishes and oversees a comprehensive performance management model, aligning provider objectives with organizational goals and translating performance data into clear expectations and improvement plans.

The Senior Manager operates independently and manages routine and team matters, escalates material provider risks and unresolved concerns, and serves as a management-level escalation point. The role cultivates a culture of ownership, accountability, proactive management, and measurable improvement, maintaining professionalism and consistency in all interactions.

Manages all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports. Responsible for driving performance to ensure that the team can lead high-level decisions that impact on the success of L.A. Care. Oversee the development, implementation, administration, and maintenance of the department's programs, policies, and procedures. Responsible for driving management and performance to ensure that the team can lead high-level decisions that impact on the success of L.A. Care.

Collaborate closely with executive/ senior management to establish goals that align with the company’s mission and vision.

Duties

Develops and implements account management strategies tailored to provider size, membership, utilization, performance, network importance, operational complexity, and relationship needs. Proactively manages provider relationships rather than relying solely on issue-driven interactions the role delivers a differentiated provider experience focused on operational processes, performance expectations, and relationship concerns. Establishes and leads structured joint operating and performance review meetings with assigned providers, emphasizing meaningful priorities, actionable data, decision-making, accountability, and measurable outcomes.

Establishes and oversees a structured performance management model that assesses quality and clinical performance, member access, utilization, member experience, operational responsiveness, care coordination, data submission and reporting, contractual performance, and regulatory compliance. Sets provider-specific performance objectives and priorities in alignment with organizational goals, translating performance information into clear, actionable expectations. Ensure teams are equipped to interpret performance data and translate findings into effective provider discussions. For entities requiring focused support, identifies, develops, and oversees provider improvement plans, defining performance deficiencies, expected outcomes, milestones, responsible parties, and completion timelines, and intervenes when improvement is insufficient.

Manages routine and team matters, escalating material provider risks, sustained underperformance, significant relationship deterioration, or issues requiring executive intervention to leadership. Serves as a management-level escalation point for unresolved provider concerns, fosters a culture of ownership, accountability, proactive management, data-driven decision-making, and measurable improvement. Maintains professionalism and consistency in all internal and external interactions, reinforcing the organization’s commitment to excellence.

Manages staff and the day-to-day activities in the department. Participates in the department budgeting process. Responsible for scheduling, training, performance, corrective actions, mentoring, and developing of the team(s). Foster and promote a culture of transparency, continuous improvement, accountability, and shared ownership of enterprise goals. Mentors and develops staff, building technical and problem-solving skills across the team.

Implements and provides guidance to the departmental and organizational processes and policies and works with senior and/or executive management to define, prioritize, and develop projects and programs.

Responsible for Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.

Responsible for overseeing and managing the budgets of their respective departments.

Manages complex projects, engaging and updating key stakeholders, developing timelines, leads others to complete deliverables on time and ensures implementation upon approval.

Plans and implements systems and procedures to maximize operating efficiency and achieve strategic priorities.

Performs other duties as assigned.

Duties Continued

Education Required

Bachelor's Degree

In lieu of degree, equivalent education and/or experience may be considered.

Education Preferred

Master's Degree

Experience

Required:

At least 7 years of extensive experience in provider relations, account management, and performance oversight within healthcare or managed care.

At least 5 years of experience in leading, supervising and/or managing staff.

Experience leading teams, projects, initiatives, or cross-functional groups.

Experience developing tailored strategies, lead structured provider meetings, and proactively managing relationships is essential.

Experience in performance management including quality assessment, compliance, and improvement planning

Preferred:

Experience with large, complex provider networks and multi-faceted operational environments.

Skills

Required:

Strong leadership skills, independent decision-making, and a track record of fostering accountability and data-driven improvement are critical.

Strong expertise in provider relations, account management, and performance oversight within healthcare or managed care.

Ability to develop and implement tailored strategies, lead structured provider meetings, and proactively manage relationships.

Advanced proficiency in performance management such as quality assessment, compliance, and improvement planning

Exceptional communication, professionalism, and consistency in all interactions are fundamental.

Strong interpersonal skills for building relationships, fostering teamwork, and creating a positive work environment. Ability to guide and support team members.

Excellent ability to set clear goals, develop strategic plans to achieve those goals, and inspire others to work towards a shared vision.

Skilled in mediating disputes and resolving conflicts in a fair and constructive manner.

Must have a deep understanding of financial principles.

Ability and excellent knowledge in developing and managing budgets, forecasting future financial outcomes, and making informed decisions about resource allocation.

Demonstrated ability to make informed decisions.

Strong verbal, written communication and presentation skills.

Deep understanding of the industry, market dynamics, and organizational operations to identify opportunities and navigate challenges.

Strong ability and knowledge to analyze market trends, anticipate future changes, and develop long-term strategies that align with the company's goals.

Preferred:

Knowledge of regulatory requirements, contractual performance standards, and advanced data analytics is highly valued.

Ability to foster a culture of ownership, proactive management, and measurable improvement, as well as strategic thinking and adaptability in dynamic organizational contexts.

Licenses/Certifications Required

Licenses/Certifications Preferred

Required Training

Physical Requirements

Light

Additional Information

Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.

L.A. Care offers a wide range of benefits including

• Paid Time Off (PTO)

• Tuition Reimbursement

• Retirement Plans

• Medical, Dental and Vision

• Wellness Program

• Volunteer Time Off (VTO)