Provider Network Operations Specialist - Hybrid

Astrana-Health-1; Riverside (CA); Hybrid; USD 34,000 - 41,000; Full time

Job summary

Astrana Health is seeking a Provider Network Operations Representative to support day-to-day provider network operations in OC-IE-SD markets, serving as a liaison among providers, internal teams, and network leadership to ensure data accuracy and timely issue resolution.

Reporting to the VP, Network Management, the role focuses on onboarding and maintenance activities, regulatory compliance, audits, and cross-functional collaboration to optimize network performance in a hybrid work environment

Qualifications

• Associate or bachelor’s degree in healthcare administration, Business, or related field (or equivalent experience).
• At least 1 year of experience in provider network operations, healthcare administration, or managed care support.
• Strong organizational skills with high attention to detail.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook).

Responsibilities

• Facilitate compliance-related activities to meet health plan, DMHC, DHCS, and regulatory requirements.
• Coordinate provider-related operational activities across internal teams such as Contracting, Credentialing, Claims, and Network Management.
• Intake and solution provider inquiries adhering to administrative processes.
• Track, research, and resolve operational issues timely and professionally.
• Maintain accurate documentation of provider records, interactions, and workflows.

Skills

Provider network operations experience

Strong organizational skills

Attention to detail

Microsoft Office Suite

Education

Associate or bachelor’s degree in healthcare administration, business, or related field

Tools

Microsoft Office

Job description

Astrana Health is seeking a Provider Network Operations Representative to support day-to-day provider network operations in OC-IE-SD markets, serving as a liaison among providers, internal teams, and network leadership to ensure data accuracy and timely issue resolution.

Reporting to the VP, Network Management, the role focuses on onboarding and maintenance activities, regulatory compliance, audits, and cross-functional collaboration to optimize network performance in a hybrid work environment