Director, Provider Relations(Must Live In Massachusetts, Preferred Experience In Provider Relations, Network Operations & Duals Plans)
Job Overview
Location
Massachusetts WFH
Job Type
Full-time
Category
HR & Recruiting
Date Posted
April 24, 2026
Full Job Description
đź“‹ Description
- • The Director, Provider Relations leads and manages relationships with key Health Partners across Massachusetts to ensure CareSource meets contractual specifications and delivers high-quality care.
- • Day-to-day responsibilities include identifying and fostering communication with Health Partners to reduce high-cost utilization, managing a team of specialists and analysts, leading quality and value-based reimbursement initiatives, overseeing budget development, and ensuring regulatory compliance.
- • The role involves collaboration with Network Management Leadership to improve response times and satisfaction, driving process improvements, and providing cross-functional leadership to align health partner communications and portal messaging.
- • The Director is responsible for hiring, training, and coaching the Health Partner Relations team, promoting team engagement, and developing performance improvement strategies in partnership with Health Partners.
- • This role offers the opportunity to lead strategic initiatives in cost of care, value-based reimbursement, and network strategy while influencing organizational outcomes through data-driven decision-making and stakeholder collaboration.
- • The position requires mobility, with over 50% travel expected, and operates in a flexible, general office environment with potential evening and weekend work.
🎯 Requirements
- • Minimum of seven (7) years of health plan/managed care experience is required
- • At least three (3) years of leadership experience preferred
- • Bachelor’s degree or equivalent work experience required; Master’s degree preferred
- • Demonstrated leadership experience, knowledge of managed care best practices, and experience driving strategic partnerships and operational improvements
- • Strong verbal and written communication skills and ability to collaborate effectively with diverse stakeholders
- • Valid driver’s license, car, and insurance required due to travel expectations (over 50% of time)
🏖️ Benefits
- • Comprehensive total rewards package including base salary and potential performance-based bonus
- • Annual Influenza vaccination support as part of employee health and safety initiatives
- • Reasonable accommodations provided for qualified individuals with disabilities, medical conditions, or sincerely held religious beliefs
- • Opportunities for professional development, leadership coaching, and team training
- • Flexible hours including possible evenings and weekends to support member needs
Skills & Technologies
About CareSource Management Group Company
CareSource is a nonprofit, multi-state managed care organization headquartered in Dayton, Ohio. Founded in 1989, it administers Medicaid, Medicare Advantage, and Marketplace health plans serving over two million members in Ohio, Kentucky, Indiana, West Virginia, and Georgia. The company focuses on improving health outcomes for low-income and vulnerable populations through integrated care management, behavioral health services, and social determinants programs.
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