Provider Network Operations & Data Specialist

AltaMed Health Services Corp; Montebello (CA); On-site; USD 37,000 - 46,000; Full time

Benefits offered by this job

Medical, Dental and Vision insurance

403(b)

Retirement savings plans with employer

Flexible Spending Accounts

Paid Time Off & Holidays

Paid CME Days

Tuition Reimbursement

Employee Discounts

Pet Care Insurance

Job summary

AltaMed Health Services Corp. is seeking a Health Plan Provider Operations Specialist in California to maintain provider data and manage Health Plan paneling across the Altura network.

You will ensure contracted providers are listed correctly, coordinate with health plans, and help ensure compliant contracts and solid business rules. The role partners with internal and external customers, supporting audits and process improvements to drive accurate network performance.

Qualifications

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

Responsibilities

• Maintain provider data and Health Plan paneling for the Altura network.
• Act as liaison between AltaMed/Altura and health plans to update networks.
• Ensure contracts via Contracting align with business rules and compliance.
• Support audits, reviews, and process improvements across provider operations.

Skills

Credentialing

Provider relations

SQL databases

Managed care knowledge

Education

Bachelor’s degree preferred

Relevant work experience accepted

Tools

SQL databases

Job description

AltaMed Health Services Corp. is seeking a Health Plan Provider Operations Specialist in California to maintain provider data and manage Health Plan paneling across the Altura network.

You will ensure contracted providers are listed correctly, coordinate with health plans, and help ensure compliant contracts and solid business rules. The role partners with internal and external customers, supporting audits and process improvements to drive accurate network performance.