Provider Quality And Network Development Manager

Central California Alliance For Health Salinas , CA 93901

Posted 2 months ago

*There is one position available that can be filled in one of our Scotts Valley, Salinas or Merced offices.

ABOUT US

We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us.

Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve approximately 350,000 members in Santa Cruz, Monterey and Merced counties. To learn more about us, click here or check out this video.

WHAT YOU'LL BE RESPONSIBLE FOR

Reporting to the Provider Services Director, you will manage provider network evaluation and development, reporting, and compliance-related activities. You will manage, supervise, mentors and train assigned staff. You will oversee operational work for Provider Services, including regulatory reporting, policy review, project participation, and training. You will also identify and implement unit- and department-level goals, objectives and performance metrics in coordination with the Provider Services Director and other department leadership.

ABOUT THE TEAM

The Provider Services team is a professional, collaborative and fun group dedicated to their mission of building healthier communities by ensuring member access to a robust network of high quality and compassionate providers. The Provider Services team is committed to building partnerships with providers by advocating for their business needs, delivering superior customer service and comprehensive provider education, as well as providing innovative provider support.

WHAT YOU'LL NEED TO BE SUCCESSFUL

  • Knowledge of:

  • Tools and techniques of data analysis and reporting

  • Healthcare industry and healthcare planning

  • California Medi-Cal program and entitlement programs

  • Tools and techniques of gap analysis and survey administration

  • Ability to:

  • Manage, supervise, mentor, train, and evaluate the work of staff

  • Organize and prioritize the work of others, delegate effectively, and follow up on work assignments

  • Utilize good judgment and tact when interacting with health care providers, members and other stakeholders

  • Act as a technical resource and explain regulations, processes, and programs related to area of assignment

  • Foster effective working relationships, influence others, and build consensus with individuals at all levels in the organization

  • Education and Experience:

  • Bachelor's degree in Healthcare Administration, Business Administration, Public Administration or a related field

  • Six years of experience (or a Master's degree and a minimum of four years) in managed care, which included a minimum of three years of management level experience related to program evaluation and/or data evaluation and a minimum of two years of supervisory experience; or an equivalent combination of education and experience which would provide the required knowledge, skills and abilities may be qualifying

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

  • Medical, Dental and Vision Plans

  • Ample Paid Time Off

  • 11 Paid Holidays per year

  • 401(a) Retirement Plan

  • 457 Deferred Compensation Plan

  • Robust Health and Wellness Program

  • EV Charging Stations

  • And many more

At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for sponsorship.


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Provider Quality And Network Development Manager

Central California Alliance For Health