Outreach, Enrollment & Provider Network Manager

Ahschc; San Leandro (CA); On-site; USD 90,000 - 130,000; Full time

Benefits offered by this job

Health Insurance

401(k) with employer match

Paid time off and holidays

Commuter benefits

Long-Term Disability

Job summary

Asian Health Services is developing SpringLight Health, a PACE program designed to deliver coordinated medical care, transportation, meals, and social activities to seniors in their communities. The Manager will build out day-to-day operations across enrollment, care coordination, and provider relations, partnering with senior leadership to ensure participant-centered service delivery.

The role emphasizes leading intake and enrollment teams, credentialing oversight, and continuous process

Qualifications

• Bachelor’s degree in healthcare administration, business, public health, or related field, or equivalent experience.
• 3+ years of experience in provider network management, contracting, provider relations, or health plan operations.
• Strong communication, relationship-building, and issue resolution skills.
• High attention to detail and ability to manage multiple deadlines in a fast-moving startup environment.
• Comfort operating in evolving, build-as-you-go environments.

Responsibilities

• Manage enrollment and disenrollment workflows, including CMS/DHCS submission tracking.
• Support Medi-Cal and Medicare eligibility verification and redetermination processes.
• Supervise Intake Coordinator(s) and Enrollment Coordinators; provide feedback and growth opportunities.
• Coordinate provider network operations including data maintenance and credentialing coordination.
• Coordinate centralized referral workflows and external appointment scheduling processes.
• Oversee operational staff and contribute to workforce and process improvements.

Skills

Communication

Relationship-building

Issue resolution

Detail-oriented

Multitasking

Analytical thinking

Process improvement

Education

Bachelor’s degree in healthcare administration or related field

Master’s degree (MBA/MHA) or related field

Job description

Imagine a center where our seniors can receive transformative health care that will allow them to age at home and in their communities.

At Asian Health Services, we recognize that so many of our elderly patients continue to struggle to get the care they need because of challenges that go beyond the walls of the clinic.

To address these gaps, we’ve found a solution and model of care that integrates the quality care our elders receive at our health center with the most comprehensive support system, like transportation, culturally-inclusive meals, and social activities, our elders deserve.

We are building aProgram of All-Inclusive Care for the Elderly (PACE) to bring life-changing, culturally competent care to low-income seniors—supporting them as they age safely and with dignity, right in their communities. Based on the PACE model, SpringLight Health will offer coordinated medical care, transportation, meals, social activities, medication management, and caregiver support—all tailored to each individual’s needs.

Learn more by visiting our website here.

Job Summary

This role presents an exciting opportunity for a detail-oriented, operationally strong professional to support the build-out and day-to-day functioning of operations for a new PACE program. The Manager will be responsible for executing and coordinating key operational workflows across enrollment, provider relations and care coordination, working closely with senior leadership to ensure participant-centered service delivery.

Enrollment & Eligibility Operations

• Manage participant enrollment and disenrollment workflows, including CMS and DHCS submission tracking
• Support Medi-Cal and Medicare eligibility verification and redetermination processes
• Identify and escal
• Supervise, coach, and develop Intake Coordinator(s) and Outreach and Enrollment Coordinators; set clear expectations, provide feedback, and support professional growth.
• Ensure that the enrollment targets are met every month by coordinating intake team staffing, and coverage
• Establish and maintain standard work, training, and job aids for intake workflows; onboard new team members as the program scales.

Provider Network & Relations

• Support provider network operations including provider data maintenance, credentialing coordination, and access management
• Serve as an operational point of contact for provider relations, issue resolution, and escalation workflows
• Monitor network adequacy and service level concerns, escalating as appropriate

Credentialing and Delegated Oversight Support

• Coordinate delegated credentialing and compliance requirements with providers and internal teams.
• Support ongoing monitoring processes (for example, OIG exclusion checks and documentation of required attestations) in partnership with compliance/quality and health plan operations.
• Track and document provider compliance with contract requirements, including timeliness of medical record return and participation in required trainings.

Care Coordination & Referral Operations

• Coordinate centralized referral workflows and external appointment scheduling processes
• Ensure timely specialty scheduling, visit note retrieval, and participant follow-through
• Collaborate with Clinical Operations and IDT teams on care transitions and participant access issues

Team & Operational Support

• May oversee one or more operational staff or coordinators as the team grows
• Contribute to workforce and process improvement initiatives as census scales
• Bachelor’s degree in healthcare administration, business, public health, or related field, or equivalent relevant experience.
• 3+ years of experience in provider network management, contracting, provider relations, or health plan operations.
• Strong communication, relationship-building, and issue resolution skills.
• High attention to detail and ability to manage multiple deadlines in a fast-moving startup environment.
• Comfort operating in evolving, build-as-you-go environments preferred
• Master's degree in Business Administration (MBA), Health Administration (MHA), or related field
• Supervisory or lead experience in health plan operations
• Experience in a startup or high-growth healthcare environment
• Strong attention to detail and follow-through
• Ability to manage multiple workflows and competing priorities
• Clear, collaborative communication across teams
• Comfort with ambiguity and a continuous improvement mindset
• Analytical and process-oriented approach to problem-solving

Benefits That Support You

We're committed to supporting our team's well-being. Our comprehensive benefits package includes:

Health & Wellness

• 100% employer-paid medical, dental & vision coverage
• Acupuncture & chiropractic coverage

Time Off

• 12 vacation days
• 12 sick days
• 12 paid holidays + 3 floating holidays (additional flexible days you can use anytime)

Financial & Retirement

• 403(b) with 3% employer contribution + up to 2% match
• Flexible Spending Account (FSA) & Dependent Care Assistance

Additional Support

• Commuter benefits
• Long-Term Disability Insurance