Provider Network Relations Specialist

Imperial Health Plan of California, Inc.; United States; On-site; USD 70,000 - 90,000; Full time

Job summary

Imperial Health Plan of California, Inc. seeks a Provider Network Administrator to manage relationships with network providers and partner health plans in Shasta County, California. The role focuses on maintaining network adequacy, addressing provider questions, and negotiating service fees.

You will onboard new providers, train them annually, resolve provider concerns, and ensure compliance with HIPAA and company policies.

Qualifications

• High school diploma or equivalent.
• Bachelor's degree in Business, Marketing, Communications or healthcare field.
• 3+ years of related experience in provider relations, network management, or related fields.

Responsibilities

• Maintain provider relations and service interactions to ensure network adequacy.
• Onboard new providers within 10 business days.
• Negotiate fees and educate providers on contracts and fee structures.
• Respond to provider and customer inquiries and resolve issues.
• Ensure compliance with HIPAA and regulatory standards.

Skills

Provider relations

Contract negotiations

Customer service

HIPAA compliance

Microsoft Office

Communication skills

Education

Bachelor's degree or higher

Tools

Excel

Word

Outlook

Job description

Imperial Health Plan of California, Inc. seeks a Provider Network Administrator to manage relationships with network providers and partner health plans in Shasta County, California. The role focuses on maintaining network adequacy, addressing provider questions, and negotiating service fees.

You will onboard new providers, train them annually, resolve provider concerns, and ensure compliance with HIPAA and company policies.