Director, Provider Relations (IDD)

Posted 11 Days Ago
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Miami, FL, USA
In-Office
Senior level
Healthtech
The Role
Lead provider relations for IDD services by developing network strategies, managing contracting and negotiations, monitoring provider performance and compliance, collaborating with clinical and quality teams, delivering training, analyzing network data, and representing the organization to stakeholders to ensure high-quality, person-centered care and regulatory adherence.
Summary Generated by Built In

We are seeking a Director of Provider Relations (IDD) to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.

About the Role:

The Director of Provider Relations (IDD) plays a pivotal role in establishing and maintaining strong, collaborative partnerships with providers serving individuals with Intellectual and Developmental Disabilities (IDD). This leadership position is responsible for developing strategic initiatives that enhance provider network capacity, quality, and compliance with regulatory standards. The role requires overseeing provider engagement, contract negotiations, and performance management to ensure the delivery of high-quality, person-centered care. The Director will work closely with internal teams and external stakeholders to address challenges, implement best practices, and drive continuous improvement in service delivery. Ultimately, this position ensures that the provider network effectively supports the health and well-being of individuals with IDD, aligning with organizational goals and regulatory requirements.

Minimum Qualifications:

  • Bachelor’s degree in Health Administration, Social Work, Nursing, or a related field.
  • Minimum of 7 years of experience in provider relations, network management, or a related role within the healthcare or IDD services sector.
  • Demonstrated knowledge of Intellectual and Developmental Disabilities service delivery systems and regulatory requirements.
  • Proven experience in contract negotiation and provider performance management.
  • Relevant experience may substitute education requirement on a year-for-year basis. 

Preferred Qualifications:

  • Master’s degree in Health Administration, Public Health, Social Work, or a related discipline.
  • Experience working within Medicaid or other government-funded IDD programs.
  • Familiarity with quality improvement methodologies and data analytics related to provider networks.

Responsibilities:

  • Lead the development and execution of provider relations strategies specific to the IDD service network to optimize provider participation and satisfaction.
  • Manage provider contracting processes, including negotiation, compliance monitoring, and renewal activities to maintain a robust and compliant provider network.
  • Collaborate with clinical, operational, and quality teams to monitor provider performance, address service gaps, and implement corrective action plans as needed.
  • Serve as the primary liaison between the organization and IDD providers, facilitating communication, resolving disputes, and fostering collaborative partnerships.
  • Analyze provider network data and market trends to inform strategic decisions and support continuous improvement initiatives.
  • Ensure adherence to all relevant federal, state, and local regulations governing IDD services and provider operations.
  • Develop and deliver training and educational resources to providers to enhance service quality and compliance.
  • Represent the organization at industry meetings, community forums, and stakeholder events to promote provider engagement and organizational objectives.

Skills Required

  • Bachelor's degree in Health Administration, Social Work, Nursing, or related field
  • Minimum of 7 years of experience in provider relations, network management, or related role within healthcare or IDD services
  • Demonstrated knowledge of Intellectual and Developmental Disabilities service delivery systems and regulatory requirements
  • Proven experience in contract negotiation and provider performance management
  • Relevant experience may substitute education requirement on a year-for-year basis
  • Master's degree in Health Administration, Public Health, Social Work, or related discipline
  • Experience working within Medicaid or other government-funded IDD programs
  • Familiarity with quality improvement methodologies and data analytics related to provider networks
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The Company
HQ: Miami, Florida
811 Employees
Year Founded: 2001

What We Do

Independent Living Systems, LLC, offers a comprehensive range of clinical and third-party administrative services to managed care organizations and providers that serve high-cost, complex member populations in the Medicare, Medicaid and Dual-Eligible Market. Independent Living Systems has been an industry leader in managing home and community-based programs for over 16 years. Leveraging ILS’ award winning technology platform, ILS provides assistance beyond the clinical realm at every stage of care from hospitalization to the treatment of chronic illnesses to personalized care management including nutritional support. As one of the country’s leading providers of Nutritional Support Services and medically tailored meals, ILS provides nutrition counseling and home delivered meals for individuals transitioning from acute settings to the home as well as for those combatting the effects of one or more chronic diseases. In partnership with health plans, providers, hospitals, and pharmaceutical and medical device companies, ILS provides solutions aimed at improving health outcomes while rebalancing costs. ILS’ suite of products and services include: MLTSS - Managed Long-Term Services Supports Suite of solutions including assessments, care management, and coordination of home and community-based services, care planning, and back-office support CCM - Comprehensive Care Management A streamlined solution for ongoing care management and care optimization targeted towards special needs populations and special needs plans Meals and Nutrition One of the nation’s largest nutritional providers delivering consistent, high-quality therapeutic meals to elderly and at-risk populations TPA – Third Party Administration A fully integrated business and technology offering to support all administrative and financial reporting requirements of health plans and risk bearing entities MSO – Management Services Organization Population and provider-based interventions to address utilization and monitor unit costs of services For more information please contact us via email at [email protected].

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