Provider Network Operations Specialist – Health Plan Data

altamed; 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  

Flexible Spending Accounts

Commuter Flexible Spending

Career Advancement & Development

Paid Time Off & Holidays

Paid CME Days

Malpractice insurance and tailcoverage

Tuition Reimbursement Program

Corporate Employee Discounts

Employee Referral Bonus Program

Pet Care Insurance

Job summary

AltaMed is seeking a Health Plan Provider Operations Specialist in California to maintain provider data and manage paneling across the Altura network. The role ensures accurate listing with contracted health plans and aligns paneling with organizational goals.

The position emphasizes process compliance, data quality, and cross‑functional collaboration with internal/external partners to monitor trends, implement improvements, and support training needs.

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.
• Knowledge of managed care preferred.

Responsibilities

• Maintain provider data and Health Plan paneling across the Altura network.
• Ensure providers are listed with contracted health plans.
• Monitor, assess, validate, and implement standard paneling procedures.
• Act as a liaison between Altura and health plans to ensure changes are made to the Provider Network.
• Assist with ensuring the quality of contracts and compliance through audits and process reviews.

Skills

Credentialing

Provider relations

Health plans coordination

SQL databases

Managed care knowledge

Education

Bachelor's degree preferred

Job description

AltaMed is seeking a Health Plan Provider Operations Specialist in California to maintain provider data and manage paneling across the Altura network. The role ensures accurate listing with contracted health plans and aligns paneling with organizational goals.

The position emphasizes process compliance, data quality, and cross‑functional collaboration with internal/external partners to monitor trends, implement improvements, and support training needs.