Provider Relations & Network Engagement Specialist

United Health Centers of the San Joaquin Valley; Fresno (CA); On-site; USD 36,000 - 44,000; Full time

Benefits offered by this job

Medical, Dental, and Vision insurance

401k plan with matching contribution

Paid time off and paid holidays

Educational Assistance

Employee discounts and more

Job summary

United Health Centers of the San Joaquin Valley seeks a Network Engagement Specialist to coordinate care for members with in-network and out-of-network providers in Fresno, CA. The role emphasizes communications with providers, handling LOAs, grievances, and referrals under MD/AMD/UM guidance.

Responsibilities include educating hospitals on UPN processes, credentialing support, and improving care transitions while maintaining strong provider relationships across networks.

Qualifications

• High School diploma or GED required.
• Bachelor's degree in Business, Health Care Administration, Communications or related field preferred.
• Completed Medical Assisting training program preferred.

Responsibilities

• Coordinate care for members with in- and out-of-network providers.
• Serve as primary intake for LOAs and authorizations.
• Review grievances and coordinate with teams and plans.
• Reroute referrals per MD/AMD/UM guidance.
• Educate hospitals and ancillary providers on UPN processes.
• Assist with provider relations, credentialing, and contract opportunities.
• Ensure accurate provider rosters and directories.

Skills

Bilingual (English/Spanish)

Communication skills

Negotiation skills

Problem-solving

Multitasking

Computer proficiency

Rapport building

Education

High School Diploma or GED

Bachelor's degree preferred

Medical Assisting training program

Job description

United Health Centers of the San Joaquin Valley seeks a Network Engagement Specialist to coordinate care for members with in-network and out-of-network providers in Fresno, CA. The role emphasizes communications with providers, handling LOAs, grievances, and referrals under MD/AMD/UM guidance.

Responsibilities include educating hospitals on UPN processes, credentialing support, and improving care transitions while maintaining strong provider relationships across networks.