Position Summary:

Under the supervision of the Provider Relations and Quality Manager, the Provider Relations Supervisor is responsible for building and maintaining strong partnerships with new and existing service providers, community agencies, and representatives. This ensures Lakeland Care, Inc. (LCI) maintains a diverse, high-quality provider network for its members.

Key responsibilities include:

• Developing and maintaining an adequate provider network.
• Establishing and monitoring service-specific rate methodologies.
• Evaluating utilization trends and community-based service contracts.
• Supervision of LCI’s Network Development, Provider Credentialing and Provider Contracting practices

The Provider Relations Supervisor also plays a critical role in fostering an environment where LCI providers can thrive by encouraging innovation and cost-effective service delivery. This role supports both external providers and internal stakeholders to ensure timely access to necessary provider resources. Additionally, the position is responsible for developing, implementing, and refining standard operating practices.

This statewide role requires close collaboration with the Residential Services Supervisor, Care Management, and Provider Relations Managers to ensure consistency in communication and practices among Provider Network staff across LCI’s service regions.

Essential Competencies:

Accountability

• Recruit and onboard new providers, particularly those enhancing community integration opportunities for members, while promoting expansion within the existing provider network.
• Maintain and update the Provider Directory, overseeing service code reviews and updates as needed.
• Ensure strong provider relationships by monitoring service trends, rate methodologies, and utilization data to support strategic decision-making.
• Supervise the Provider Specialist and Development Specialist teams, ensuring adherence to standard operating practices, procedures, and policy.
• Provide leadership that reflects LCI’s mission, vision, and values, fostering a success-oriented and accountable work environment
• Solve problems with a member-centered, outcome-driven, and solution-focused approach
• Support Lakeland Care’s Strategic Plan by ensuring provider relations align with organizational goals and network adequacy requirements
• Demonstrate expertise in service provider contracting, regulatory requirements, the DHS Family Care Contract, service rates, and the impact of contracting decisions.
• Establish performance standards, provide clear direction, hold staff accountable, and foster professional development through regular feedback and support
• Provide ongoing updates and data analysis to the Provider Relations and Quality Manager and the Provider Relations Senior Manager on nonresidential service trends, network adequacy, and process improvements.

Critical Thinking

• Use cost and utilization data to drive decision making and proactively address changing member needs
• Analyze and apply internal and external network capacity requirements to ensure adequate provider availability
• Develop, monitor, and refine sustainable rate methodologies for nonresidential services
• Identify and implement creative solutions to strengthen the Family Care provider network and future LCI programs
• Collaborate with internal stakeholders to develop innovative service models that align provider capacity with member needs and utilization trends.
• Assist in the development, implementation, and continuous improvement of policies, procedures, best practices, credentialing standards, provider relations strategies, and overall business strategies

Commitment to Excellence

• Apply performance improvement strategies to enhance service quality and organizational effectiveness
• Maintain high productivity while effectively managing competing demands, ambiguous tasks, and interruptions
• Identify and recommend innovative ways to optimize resources and better support member needs.
• Demonstrate a strong customer service focus, clear communication, and the ability to navigate complex stakeholder relationships.
• Ensure timely and effective communication with all stakeholders to foster collaboration and trust.
• Provide prospective providers with an overview of Lakeland Care and the Family Care program to support informed engagement

Interpersonal Awareness

• Exhibit maturity, resilience, and sound judgment when addressing challenges and making high-impact decisions.
• Maintain professionalism by demonstrating appropriate emotional responses and performing effectively under pressure.
• Approach demanding situations constructively, resolve conflicts appropriately, and foster a positive work environment.
• Communicate openly and transparently with LCI contracted providers and internal teams to enhance organizational practices.
• Respect diverse perspectives, opinions, and concerns, valuing inclusivity in thought and action.
• Act with honesty, trust, and integrity in all interactions.
• Be receptive to feedback and continuously seek opportunities for growth and improvement.

Relationship Building

• Motivate and lead a high-performing team by attracting, recruiting, mentoring, and professionally developing employees.
• Delegate responsibilities to foster employee growth and contribute to the success of Lakeland Care.
• Actively mentor and develop leadership internally while supporting leadership growth among providers and key stakeholders.
• Influence others through positive reinforcement, teamwork, and expertise in provider relations.
• Establish and maintain strong relationships with service providers, community organizations, and stakeholders.
• Conduct regularly scheduled provider meetings and assist in coordinating residential and non-residential provider forums to educate on agency procedures, service delivery, and contract standards.
• Attending community and networking events, as well as conferences, to recruit new providers.
• Oversee new provider inquiries and initiate outreach to expand the network.
• Assist in creating provider communications, including the Provider Handbook, newsletters, and Provider Network Advisory Committee materials.
• Coordinate activities with both network and non-network providers to ensure service availability and the inclusion of natural community resources within the network.
• Foster strong interdepartmental relationships and maintain frequent collaboration across divisions.

Organizational Regard

• Lead and actively participate in strategic initiatives that drive performance excellence while modeling Lakeland Care’s (LCI) Mission, Vision, and Core Values.
• Foster strong interdivisional collaboration, particularly with Utilization and Care Management divisions, to address member needs, interpret data, and implement action plans.
• Provide internal education and support on contracts, addendums, provider resources, and enhance understanding of provider expertise.
• Promote continuous improvement by evaluating systems, providing honest and timely feedback, and supporting organizational change.
• Organize, facilitate, and contribute to LCI stakeholder and provider meetings/forums, while representing LCI at professional events both internally and externally.
• Collaborate with IDT staff, attending meetings as needed to discuss provider updates and issues, educate on contracts and provider resources, and strengthen provider partnerships.
• Demonstrate LCI’s core values of Kindness, Inclusion, and Trust in all interactions and initiatives.

The duties listed above are typical for this position. These are not to be construed as exclusive or all-inclusive. Other duties may be required and assigned.

Work Relationships and Scope:

This position reports directly to the Provider Relations and Quality Manager and oversees the Provider Specialists and Provider Development Specialists. Most responsibilities are carried out independently, with collaboration from LCI staff as needed. The Provider Relations Supervisor interacts regularly with providers, Interdisciplinary Teams (IDTs), Care Management Supervisors, Quality staff, the Department of Health Services, community agencies, and LCI leadership. 

Working Conditions:

Work is conducted in either an office or telework setting, with minimal risk of personal injury. The role involves responding to various operational, community, customer, and employee situations while managing multiple priorities within established deadlines. Additionally, the individual may serve as a representative of the organization at appropriate functions.

This is a salaried leadership position, and the work schedule will be determined by organizational, and team needs. A high level of independence in managing the work schedule is essential.

Qualifications:

To successfully perform this job, an individual must be able to satisfactorily complete each essential duty. The attributes listed below represent the knowledge, skills, and abilities appropriate for the level of work performed:

• Education: Bachelor’s degree in accounting, Business, Social Work, Healthcare Administration, or a related field, or an equivalent combination of education and experience (including knowledge, skills, and abilities).
• Leadership Experience: Minimum of three (3) years of leadership experience in healthcare, long-term care, or the health insurance industry. Two (2) to four (4) years of experience in contract negotiation supporting purchaser-provider business relationships, preferably in long-term care or acute and primary healthcare.
• Analytical Skills: Proficiency in analyzing healthcare financial and utilization data.
• Industry Knowledge: Understanding of the service provider industry, subcontracting, licensing, regulatory systems, and provider network contracting in a managed care model is preferred.
• Regulatory Knowledge: Familiarity with federal and state rules and regulations governing Medicaid and Medicaid waiver programs.
• Managed Care Principles: Demonstrated knowledge of managed care principles.
• Communication Skills: Ability to read, analyze, and interpret business documents and engage in advanced professional communications.
• Attention to Detail: Capability to work under time constraints while maintaining attention to detail.
• Interpersonal Skills: Ability to respond effectively to sensitive inquiries and situations.
• Diverse Communication: Proven ability to communicate with various segments of the general population and the professional community.
• Communication Proficiency: Excellent verbal and strong written communication skills are required.
• Organizational Skills: Outstanding organizational skills with the ability to manage multiple responsibilities.
• Desired Experience: Experience, training, or skills in mediation and negotiations, analyzing and interpreting data for strategic planning and system implementation, and delivering training and presentations to groups.
• Licensing: A current driver’s license, an acceptable driving record, and proof of adequate insurance are required.