Provider Services Lead - Medicare Ops & IPA

Verda Healthcare; Huntington Beach (CA); On-site; USD 70,000 - 80,000; Full time

Benefits offered by this job

401(k)

Paid time off

Health insurance

Dental Insurance

Vision insurance

Life insurance

Job summary

Verda Healthcare, Inc. in Huntington Beach, CA seeks a Provider Services Manager to lead the daily operations of the Provider Services department, ensuring timely, accurate support for providers, delegated IPAs, and internal partners.

The role requires 3–5 years in provider services or healthcare operations with supervisory experience, plus knowledge of Medicare Advantage and CMS requirements. This on-site position offers competitive compensation and benefits.

Qualifications

• 3–5 years of experience in provider services/healthcare operations with supervisory responsibilities.
• Experience with Medicare Advantage plans and delegated networks is strongly preferred.
• Ability to manage multiple priorities in a fast-paced environment.
• Excellent written and verbal communication and relationship-management skills.
• Experience with provider data management and credentialing is preferred.
• Bachelor’s degree in healthcare administration or a related field is required.

Responsibilities

• Oversee day-to-day operations of the provider services department, serving as the primary operational resource for provider inquiries and portal support.
• Coordinate delegated IPA collaboration, issue resolution, and provider demographic updates.
• Lead onboarding for IPAs and providers; manage provider communications and policy updates.
• Escalate provider inquiries in collaboration with claims, utilization management, credentialing and other teams.
• Organize quarterly Joint Operations Committee meetings with IPAs and hospitals.
• Coordinate provider data validation and directory accuracy with Credentialing and Provider Data Management.
• Develop and maintain SOPs; participate in improvement projects impacting provider and member experiences.
• Perform other duties as assigned.

Education

Bachelor’s degree in healthcare administration

Tools

Microsoft Office Suite

Healthcare management systems

Job description

Verda Healthcare, Inc. in Huntington Beach, CA seeks a Provider Services Manager to lead the daily operations of the Provider Services department, ensuring timely, accurate support for providers, delegated IPAs, and internal partners.

The role requires 3–5 years in provider services or healthcare operations with supervisory experience, plus knowledge of Medicare Advantage and CMS requirements. This on-site position offers competitive compensation and benefits.