Director, Provider Engagement

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Director, Provider Engagement

Job Category: Provider Relations

Department: Provider Network Management

Location: Los Angeles, CA, US, 90017

Position Type: Full Time

Requisition ID: 13347

Salary Range: $149,502.00(Min.) -$201,827.00(Mid.) -$254,152.00(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.

Duties

Leads the provider engagement agenda, establishes a disciplined and scalable operating model that moves relationships beyond transactional exchanges and into long-term strategic alliances anchored in shared accountability. Defines the standards for engagement frequency, communication protocols, and executive participation, ensuring each partnership progresses through structured planning cycles and is supported by clear, measurable objectives. By convening executive business reviews, advisory councils, partnership forums, and joint operating committees, creates reliable mechanisms through which strategic priorities, emerging needs, and ongoing feedback are surfaced, addressed, and continuously aligned.

In collaboration with key stakeholders, shepherds the development and deployment of value-based care programs, including shared savings and risk arrangements, capitation, bundled payments, and pay-for-performance models. Ensures that provider organizations fully understand attribution methodologies, incentive structures, benchmarks, and performance expectations, enabling participants to execute confidently and consistently against program goals.

Orchestrates an integrated performance management approach that synthesizes quality outcomes, utilization patterns, cost efficiency, access standards, care coordination effectiveness, claims performance, operational reliability, member experience measures, and regulatory requirements into a unified framework. Guides strategic improvement efforts across the network with respect to affordability, quality outcomes and improved member experience.

Support executive decision-making, distills complex financial, operational, utilization, and quality data into concise and actionable insights for senior leadership and governance bodies. Maintains rigorous oversight of Medi-Cal, Medicare, DMHC, DHCS, CMS, and NCQA requirements, ensuring alignment between provider engagement efforts and broader compliance obligations. Represents the organization in high-visibility external engagements, serving as a strategic ambassador in provider meetings, community forums, and partnership discussions that shape the regional healthcare landscape.

Leads and develops a high‑performing team of engagement professionals capable of managing differentiated and sophisticated relationships across diverse provider segments. Ensures the team operates proactively, strategically, and with a consistent focus on outcomes, reinforcing a culture of disciplined engagement and enterprise alignment.

Conduct strategic planning to utilize resources in order to meet current and future departmental and Enterprise-wide goals. Manages budgets and resources effectively. Identifies and actualizes enhancements to support company vision.

Lead discussions on policy operationalization and manage key policy perspective sharing.

Develops goals, objectives and actions plans for assigned staff which includes full management responsibility for the hiring, performance reviews, salary reviews and disciplinary matters for direct reporting employees. Foster and promote a culture of transparency, continuous improvement, accountability, and shared ownership of enterprise goals.

Performs other duties as assigned.

Job Summary

The Director, Provider Engagement serves as the organization’s strategic relationship architect, responsible for cultivating and elevating high-impact partnerships across hospitals, health systems, IPAs, medical groups, and delegated entities. In this capacity, the Director designs and leads an enterprise-wide engagement model that brings strategic priorities, quality goals, operational expectations, financial constructs, and transformative initiatives into alignment with provider leadership. The role ensures this alignment translates into measurable improvements in cost, quality, access, utilization, operational reliability, and member experience.

Functions as a primary external representative to provider C-suite and medical executives, the Director builds trusted relationships grounded in transparency, shared priorities, and strategic collaboration. Through executive forums and joint planning structures. Ensures provider perspectives actively inform organizational strategy while accelerating the system’s transformation toward value-based care. Conveys exceptional strategic judgment, analytical rigor, and executive presence while navigating highly complex, high-stakes environments where partnership outcomes influence overall system performance.

This position oversees operations, ensuring efficiency and effectiveness. It is responsible for directing all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports.

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 8 years of experience from within health plans, hospital systems, medical groups, IPAs, or healthcare consulting environments.

At least 7 years of progressive responsible experience in leadership roles directly overseeing provider engagement, strategic partnerships, contracting, network management, or performance management initiatives.

At least 6 years of leading staff, supervising staff or people management experience.

Experience working with provider C-suite leaders and medical executives, demonstrating an ability to influence and collaborate effectively in high-stakes environments where clinical, operational, and financial considerations intersect.

Experience designing and implementing value-based programs involving shared savings, shared risk, capitation, and bundled payment methodologies.

Preferred:

Experience with government-sponsored programs such as Medi-Cal and Medicare, along with experience in designing value-based incentive structures and provider reimbursement models.

Experience presenting to Boards, negotiating complex multi-party partnerships, and navigating shared governance environments reflects a high degree of executive maturity valuable to this role.

Experience with Los Angeles County’s landscape provider and strategic ecosystem further enhance readiness for the role.

Skills

Required:

Exceptional executive relationship management capabilities and the ability to influence decisions within complex, multi-stakeholder environments. Excellent interpersonal skills for building relationships, fostering teamwork, and creating a positive work environment.

Demonstrated advanced strategic planning and change-management skills.

Ability to design scalable engagement models and long‑range partnership strategies.

Excellent ability and knowledge in analyzing data, identifying problems, and making informed decisions, often in complex or ambiguous situations. Ability to transform data related to claims, utilization, quality, and financial performance into executive-ready insights that inform strategic action.

Expert knowledge of managed care operations, provider contracting, network management, reimbursement methodologies, delegated risk structures, and quality-improvement frameworks.

Exemplary communication skills, with the ability to craft and deliver compelling presentations suitable for C-suite audiences, strategic forums, and board-level reporting.

Deep knowledge and familiarity with attribution logic, incentive design, performance benchmarks, and the overall mechanics that drive value-based program success.

Knowledge of HEDIS, CAHPS, quality incentive programs, utilization management processes, and population‑health analytics.

Strong knowledge and understanding of regulatory frameworks spanning Medi-Cal, Medicare, DMHC, DHCS, CMS, and NCQA.

Demonstrated ability to think long-term and develop strategies that align with the overall goals of the organization.

Demonstrated ability to make sound and timely decisions.

Demonstrated ability to adapt to changing situations and adjust strategies accordingly.

Demonstrated ability to adapt to a fast-paced and evolving environment and to lead others through change.

Licenses/Certifications Required

Licenses/Certifications Preferred

Required Training

Physical Requirements

Light

Additional Information

Required:
Travel to offsite locations for work required.

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 offersa wide range of benefits including

• Paid Time Off (PTO)
• Tuition Reimbursement
• Retirement Plans
• Medical, Dental and Vision
• Wellness Program

Nearest Major Market: Los Angeles
Job Segment: Healthcare Consultant, Medicare, Claims, Relationship Manager, Performance Management, Healthcare, Insurance, Customer Service, Human Resources

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