Director, Provider Relations (IDD)

We are seeking a Director, 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.