Strategic Provider Operations & Process Optimization Lead

L.A. Care; Los Angeles (CA); On-site; USD 110,000 - 182,000; Full time

Benefits offered by this job

Paid Time Off (PTO)

Tuition Reimbursement

Retirement Plans

Medical, Dental and Vision

Wellness Program

Job summary

L.A. Care Health Plan in Los Angeles, CA, is seeking an Advisor in Provider Operations and Process Optimization.

This full-time role partners with senior leadership to translate strategy into operational reality, assessing workflows, and implementing improvements for efficiency and provider experience through refined metrics and reporting tools. The Advisor guides managed care program design, implementation, and evaluation, ensuring regulatory updates are embedded into controls and

Qualifications

• Bachelor's degree or equivalent experience in business, healthcare operations, or related field.
• Minimum 5 years in managed care operations, regulatory compliance, provider relations, or project management.
• Experience driving continuous improvement and cross-functional collaboration.

Responsibilities

• Advance organizational excellence through strategic partnerships, regulatory stewardship, managed care program support, and provider engagement.
• Translate enterprise strategy into operational execution; assess provider workflows and propose improvements for efficiency and compliance.
• Develop performance metrics, dashboards, and reporting tools for leadership insights.
• Serve as SME on regulatory and contractual requirements; implement cross-functional communications for regulatory changes.
• Support design, launch, and evaluation of managed care programs; manage timelines, resources, and deliverables.
• Improve provider notices, bulletins, and portal communications; contribute to Universal Provider Manual updates.
• Identify areas for technical solutions to improve performance and ensure program deliverables meet policies and standards.

Skills

Regulatory compliance

Provider relations

Data analysis

Process improvement

Dashboard reporting

Cross-functional collaboration

Strategic thinking

Communication

Education

Bachelor's Degree in Business Administration or Related Field

In lieu of degree, equivalent education/experience

Job description

L.A. Care Health Plan in Los Angeles, CA, is seeking an Advisor in Provider Operations and Process Optimization.

This full-time role partners with senior leadership to translate strategy into operational reality, assessing workflows, and implementing improvements for efficiency and provider experience through refined metrics and reporting tools. The Advisor guides managed care program design, implementation, and evaluation, ensuring regulatory updates are embedded into controls and