Provider Network Administrator

AltaMed Health Services; Montebello (CA); On-site; USD 69,000 - 86,000; Full time

Benefits offered by this job

Medical, Dental and Vision insurance

403(b) Retirement savings

Flexible Spending Accounts

Career Advancement

Paid Time Off

Tuition Reimbursement

Pet Care Insurance

Job summary

AltaMed Health Services is seeking a Provider Network Administrator in Montebello, CA. The role focuses on negotiating and maintaining contracts with healthcare providers to ensure a compliant and cost-effective network.

Successful candidates will have strong communication skills and a solid understanding of the healthcare industry. The position offers competitive compensation and benefits, including medical insurance, retirement plans, and career development opportunities.

Qualifications

• 2 years of relevant experience in provider contracting or 3 years in lieu of a degree.
• Experience in Managed Care setting preferred.
• Familiarity with Medicaid, Medicare, or Commercial networks preferred.

Responsibilities

• Negotiate and administer contracts with healthcare providers.
• Ensure compliance with regulations related to provider networks.
• Track progress and enhance brand visibility.

Skills

Negotiation

Contract Management

Communication Skills

Detail Oriented

Healthcare Knowledge

Education

Bachelor's degree in related field

Tools

Contract Lifecycle Management Systems

Provider Databases

Job description

Grow Healthy

If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn’t just welcomed – it’s nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don’t just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it’s a calling that drives us forward every day.

Grow Healthy

If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn’t just welcomed – it’s nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don’t just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it’s a calling that drives us forward every day.

Job Overview

The Provider Network Administrator is responsible for negotiating, administering, and maintaining contracts and relationships (i.e. Primary Care Physician (PCP), specialist, ancillary providers, hospitals) to ensure a high-quality, cost-effective, and compliant provider network. This role supports managed care growth initiatives and organizational goals. Key responsibilities include identifying and onboarding new providers, ensuring regulatory compliance, and fostering strong partnerships with existing partners. The Provider Network Administrator will also assist in tracking progress, enhancing brand visibility, and supporting efforts to secure new contracts. Success in this role requires strong communication skills, attention to detail, and a solid understanding of the healthcare industry.

Minimum Requirements

• Bachelor's degree in a related field with 2 years of relevant experience (i.e. provider contracting, contract interpretation, negotiation, client relations) or 3 years of relevant experience in lieu of a degree.
• Healthcare experience in a Managed Care setting or with a physician group, clinical-based organization, and/or in a hospital/facility setting preferred.
• Experience with Medicaid, Medicare Advantage, or Commercial provider networks preferred.
• Experience with contract lifecycle management systems and provider databases preferred.
• Experience with provider reimbursement methodologies (e.g., fee-for-service, capitation, value-based models) preferred.
• Experience with healthcare regulatory requirements (e.g., CMS, DHCS, DMHC, NCQA) related to provider networks preferred.

Compensation

$68,640.00 - $85,800.00 annually

Compensation Disclaimer

Actual salary offers are considered by various factors, including budget, experience, skills, education, licensure and certifications, and other business considerations. The range is subject to change. AltaMed is committed to ensuring a fair and competitive compensation package that reflects the candidate's value and the role's strategic importance within the organization. This role may also qualify for discretionary bonuses or incentives.

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

Job Advertisement & Application Compliance Statement

AltaMed Health Services Corp. will consider qualified applicants with criminal history pursuant to the California Fair Chance Act and City of Los Angeles Fair Chance Ordinance for Employers. You do not need to disclose your criminal history or participate in a background check until a conditional job offer is made to you. After making a conditional offer and running a background check, if AltaMed Health Service Corp. is concerned about a conviction directly related to the job, you will be given a chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.