Provider Relations & Network Development Specialist

Nexus HR; El Monte (CA); On-site; USD 41,000 - 55,000; Full time

Benefits offered by this job

Company car provided

Job summary

Nexus HR in El Monte, CA is seeking a Provider Relations Specialist to develop and manage provider networks, contracts, and education for an IPA-based program. The role supports network development, negotiates contracts, and reviews HEDIS measures while ensuring access standards across a CA-wide network.

The ideal candidate has healthcare contracting experience, familiarity with IPA structures, and is fluent in Spanish.

Qualifications

• 2 years of experience in healthcare provider contracting.
• 3 years of experience with large health systems, FQHCs, RHCs.
• Experience working for an IPA or medical group and with a payer.

Responsibilities

• Develop and manage provider relationships and contracting.
• Handle HEDIS and gaps in care reporting with providers.
• Maintain documentation for provider contracts via CRM.
• Liaise between network providers and our organization to ensure access standards.
• Negotiate cost-effective contracts in compliance with state and client requirements.
• Travel as needed to Central and Southern CA regions.

Skills

Healthcare contracting

IPA/Medical group contracting

Spanish language

Contract negotiation

Tools

CRM

Job description

Nexus HR in El Monte, CA is seeking a Provider Relations Specialist to develop and manage provider networks, contracts, and education for an IPA-based program. The role supports network development, negotiates contracts, and reviews HEDIS measures while ensuring access standards across a CA-wide network.

The ideal candidate has healthcare contracting experience, familiarity with IPA structures, and is fluent in Spanish.