Provider Network Specialist jobs in California

We have an opportunity to join the Alliance as a Provider Network Development Specialist supporting the brand new team focused on recruitment and expansion of our provider network for the Provider Services Department.  This position has regular/ frequent in-community requirements within the Alliance service counties including Santa Cruz, San Benito, Mariposa, Merced, Monterey.

WHAT YOU'LL BE RESPONSIBLE FOR

Reporting to the Provider Network Development Manager, this position: 

1. Conducts and coordinates professional level healthcare provider recruitment efforts and related activities
2. Facilitates the onboarding process for new providers
3. Performs research and analysis related to provider network requirements and to identify opportunities for network expansion
4. Performs other duties as assigned

ABOUT THE TEAM

From outreach and recruitment to educating and supporting our Provider Network, we're the team who establishes, builds, and maintains our positive working relationship with local providers. 

THE IDEAL CANDIDATE 

• Proficient in identifying, recruiting, and contracting with a diverse range of healthcare providers to ensure a comprehensive, high-quality network
•  Skilled in building and maintaining strong relationships with prospective providers through regular direct contact and effective communication
• Collaborates with legal and compliance departments to ensure all provider contracts adhere to regulatory requirements and organizational standards
• Conducts thorough market research and analysis to identify gaps in the provider network and opportunities for expansion
• Actively supports and implements process improvements in provider recruitment and onboarding

WHAT YOU'LL NEED TO BE SUCCESSFUL

To read the full position description, and list of requirements click here.

• Knowledge of:
  • Principles and practices of healthcare provider recruitment
  • Healthcare delivery systems, including hospitals, clinics, and other healthcare provider types
  • Health care industry and managed care concepts
  • Research, analysis, and reporting methods
  • California Medi-Cal program and related regulations
• Ability to:
  • Ability to develop and implement effective provider recruitment processes
  • Conduct provider outreach in a positive and professional manner that builds relationships and ability to take initiative to follow up with prospective providers as appropriate
  • Identify providers’ priorities and how the Alliance can meet providers’ needs
  • Apply sales and marketing skills when conducting provider recruitment activities
  • Interpret, apply, and explain policies, standards, regulatory requirements, and guidelines

Education and Experience:

• Bachelor’s degree in Healthcare Administration, Business Administration, Social Science, or a related field
• Minimum of four years of experience in a managed care environment performing provider network development, provider relations and/or provider contracting activities, which included a minimum of two years of experience performing provider recruitment activities and some experience working with Medi-Cal
• A Master’s degree may substitute for two years of the required experience); or an equivalent combination of education and experience may be qualifying

OTHER INFORMATION

• We are in a hybrid work environment and we anticipate that the interview process will take place remotely via Microsoft Teams.
• While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected.
• In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process.

The full compensation range for this position is listed by location below. 

The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferrable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location).