Provider Relations – Market Performance Lead

We are currently seeking a highly motivated Provider Relations Market Performance Lead in the Beaumont area who will serves as a strategic, field-based partner to physician practices, supporting improvements in clinical quality, risk adjustment, operational efficiency, and financial performance. This role works directly with primary care and specialty practices to analyze performance, identify root causes of gaps, and lead practice transformation efforts through provider education, workflow redesign, and data-driven interventions. While clinical licensure is not required, the role demands a strong working knowledge of clinical workflows, quality measures, and managed care operations to effectively engage providers and drive sustainable improvement. What You'll Do Provider Relationship & Performance Management Serve as the primary business and operational liaison for approximately 50–60 assigned primary care and specialty physician practices, representing the organization in matters requiring professional judgment. Establish and maintain strong, ongoing advisory relationships with physicians, clinicians, and practice staff through routine on-site and remote engagement. Conduct regular provider visits to assess performance, identify barriers, and support improvement initiatives. Document provider interactions, action plans, follow-ups, and outcomes to support continuous improvement and executive decision making Clinical Quality, Risk, and Performance Improvement Analyze, interpret, and present provider performance reports including HEDIS, risk adjustment, pay-for-performance, medical cost ratio (MCR), and other value-based performance metrics. Provide subject-matter guidance and education to providers on clinical quality measures, documentation standards, risk adjustment, coding accuracy, and gap closure strategies. Coach providers on managing patients with multiple chronic conditions and appropriate inpatient utilization. Identify trends, variances, and root causes of underperformance and develop targeted, data-driven improvement plans. Practice Operations & Transformation Lead and influence workflow design and redesign initiatives, including EHR optimization, clinical documentation improvement, and care team workflow efficiency. Provide billing, claims, and encounter resolution support and partner with practices to improve submission accuracy and timeliness. Determine and implement corrective actions to address financial, operational, and quality performance gaps. Oversee provider onboarding, orientation, and ongoing education to ensure compliance with state, federal, and organizational standards, applying professional judgment in interpretation and execution. Cross-Functional Collaboration Act as a key partner with internal teams including Quality Improvement, Risk Adjustment, Operations, and Provider Services to resolve provider issues and improve outcomes. Lead or contribute to cross-functional and regional initiatives impacting provider, market, and organizational performance. Communicate complex performance expectations and improvement strategies clearly to executive leadership, internal