Health Plan Provider Operations & Compliance Specialist

AltaMed Health Services Corporation; Montebello (CA); Hybrid; USD 37,000 - 47,000; Full time

Benefits offered by this job

Medical, Dental and Vision insurance

403(b) Retirement savings plans withem

Flexible Spending Accounts

Commuter Flexible Spending

Career Advancement & Development

Paid Time Off & Holidays

Tuition Reimbursement Program

Employee Referral Bonus Program

Pet Care Insurance

Job summary

AltaMed Health Services Corporation is seeking a Health Plan Provider Operations Specialist to maintain provider data and manage paneling with health plans across the Altura network. The role focuses on accurate contracts, compliance, and process improvements.

The position requires credentialing or provider relations experience, knowledge of managed care, and SQL database usage. Hybrid collaboration with internal teams and external plans is essential.

Qualifications

• Bachelor’s degree preferred, or relevant work experience required.
• Minimum of 1 year of credentialing and/or provider relations experience required.
• Minimum of 1 year of interaction with multiple health plans preferred.
• Minimum of 2 years of experience using SQL databases preferred.

Responsibilities

• Maintain provider data and Health Plan paneling for the Altura network.
• Ensure provider listings are contracted with health plans across lines of business.
• Monitor and audit paneling processes for compliance and risk management.
• Liaise between Altura and health plans to update the Provider Network.

Skills

Credentialing

Provider relations

Stakeholder management

Education

Bachelor’s degree

Tools

SQL databases

Job description

AltaMed Health Services Corporation is seeking a Health Plan Provider Operations Specialist to maintain provider data and manage paneling with health plans across the Altura network. The role focuses on accurate contracts, compliance, and process improvements.

The position requires credentialing or provider relations experience, knowledge of managed care, and SQL database usage. Hybrid collaboration with internal teams and external plans is essential.