Senior Provider Relations Specialist – Medi-Cal & Health Equity

Blue Shield of CA; Oakland (CA); Hybrid; USD 65,000 - 85,000; Full time

Job summary

Blue Shield of CA is seeking an Experienced Provider Relations Representative to support provider participation and engagement for the CalAIM program in California.

This hybrid role requires strong analytical skills, knowledge of medical terminology, and the ability to coordinate with IPA/Medical groups and hospitals to deliver coordinated, high-quality Medi-Cal care while advancing health equity goals.

Qualifications

• Bachelor's degree or HS diploma with 4 years of relevant experience.
• 3 years of prior relevant experience.
• Strong analytical, critical thinking, and problem-solving skills.
• Proficient in Microsoft Office applications (Excel, Word, Access, Outlook).
• Knowledge of medical terminology and healthcare industry concepts.
• Experience with Medi-Cal, Medicaid, or similar programs preferred.
• Ability to work independently and manage multiple assignments.
• Excellent organizational skills with attention to detail.

Responsibilities

• Support provider participation and engagement in CalAIM.
• Assist in delivering coordinated, high-quality Medi-Cal care.
• Contribute to program success and health equity initiatives.

Skills

Analytical thinking

Problem solving

Independent worker

MS Office proficiency

Healthcare industry knowledge

Education

Bachelor's degree or HS diploma with 4 years of relevant experience

Tools

Microsoft Excel

Microsoft Word

Microsoft Access

Microsoft Outlook

Job description

Blue Shield of CA is seeking an Experienced Provider Relations Representative to support provider participation and engagement for the CalAIM program in California.

This hybrid role requires strong analytical skills, knowledge of medical terminology, and the ability to coordinate with IPA/Medical groups and hospitals to deliver coordinated, high-quality Medi-Cal care while advancing health equity goals.