Provider Relations Specialist, IPA Network Operations

Work Boldly. Live Brilliantly.

At AltaMed, we don't just serve our communities, we are part of them. We have raised the expectations of what a community clinic can deliver because we think quality care is for everyone. And, we are determined to provide it no matter the challenges because this is more than a job. It's the calling of our lives and it compels us to keep moving forward.

Job Overview

The Provider Relations Specialist - IPA Network Operations position is a direct operational liaison between AltaMed and the contracted provider network, fostering a strong and collaborative relationship with IPA physicians and their office staff. This position is responsible for providing physicians and their staff with timely network updates, ongoing education and training, and tools and resources to drive performance and growth. Working closely with internal teams, the Provider Relations Specialist will address provider requests in a timely manner and proactively identify issues and recommend solutions, while specifically focusing on key performance indicators for improvement opportunities as well as membership growth and retention strategies. This role requires a knowledge of managed care operations and provider reimbursement structures as well as customer service excellence and relationship building.

Minimum Requirements:

1.Bachelor's degree in Business Administration or Health Care Administration required or equivalent years of experience.

2.Minimum of 3 years of experience working in a managed care health care environment, health plan, medical group, or provider office required.

3.Experience in provider relations and customer service.

4.Knowledge of: HEDIS, CAHPS, HOS, Hierarchical Condition Category (HCC), Risk Adjustment Factor (RAF) score, CPT and ICD coding systems.

Benefits & Career Development

• Medical, Dental and Vision insurance

• 403(b) Retirement savings plans with employer matching contributions

• Flexible Spending Accounts

• Commuter Flexible Spending

• Career Advancement & Development opportunities

• Paid Time Off & Holidays

• Paid CME Days

• Malpractice insurance and tail coverage

• Tuition Reimbursement Program

• Corporate Employee Discounts

• Employee Referral Bonus Program

• Pet Care Insurance