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Entry Level Provider Network Development Jobs in California

Astiva Health

Contract Coordinator

Orange, CA · On-site

$25 - $30/hr

Minimum of one (1) year of experience in provider network development and/or provider network management capacity, account management, or provider relations experience in a managed care organization.

Astiva Health

Contract Coordinator

Orange, CA · On-site

Minimum of one (1) year of experience in provider network development and/or provider network management capacity, account management, or provider relations experience in a managed care organization.

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Entry Level Provider Network Development information

What is an Entry Level Provider Network Development role?

An Entry Level Provider Network Development role involves assisting in building and maintaining relationships between healthcare providers and health insurance companies. Professionals in this position help with tasks such as recruiting new providers, ensuring contract compliance, and gathering necessary documentation. They support the network team by performing data entry, preparing reports, and communicating with providers to resolve any issues. This role serves as a foundation for understanding the healthcare network process and often provides opportunities for career growth within the industry.

What job makes $10,000 a month without a degree?

Entry Level Provider Network Development roles typically do not pay $10,000 a month without significant experience or advanced skills. High-paying jobs that reach this level often require specialized knowledge, certifications, or experience in fields like sales, real estate, or entrepreneurship, rather than entry-level positions. Most roles at this income level are not accessible without relevant qualifications or extensive experience.

What are some common challenges faced by entry level professionals in provider network development, and how can they overcome them?

Entry level professionals in provider network development often face challenges such as building relationships with healthcare providers, navigating complex insurance regulations, and quickly learning industry terminology. To overcome these hurdles, it helps to proactively seek mentorship from experienced colleagues, attend trainings or workshops, and regularly review internal documentation and industry guidelines. Strong communication skills and a willingness to ask questions can also make it easier to collaborate with team members and external partners, leading to greater confidence and success in the role.

What jobs pay $2000 a day?

Entry level provider network development roles typically do not pay $2000 a day; such high daily rates are usually associated with highly specialized or senior healthcare consulting, medical director positions, or independent contractor roles in healthcare management. These roles often require extensive experience, certifications, and a strong professional network.

What are the key skills and qualifications needed to thrive as an Entry Level Provider Network Development professional, and why are they important?

To thrive as an Entry Level Provider Network Development professional, you need a basic understanding of healthcare systems, strong analytical skills, and a bachelor's degree in healthcare administration, business, or a related field. Familiarity with provider management software, claims processing systems, and proficiency in Microsoft Excel are commonly required technical competencies. Strong interpersonal communication, negotiation skills, and attention to detail help you build relationships with providers and manage contracts effectively. These skills are crucial for ensuring robust provider networks, supporting organizational goals, and maintaining compliance with regulatory requirements.

What is the difference between Entry Level Provider Network Development vs Entry Level Provider Relations Coordinator?

AspectEntry Level Provider Network DevelopmentEntry Level Provider Relations Coordinator
CredentialsTypically requires a bachelor's degree in healthcare, business, or related fieldSimilar educational background, often with healthcare or business focus
Work EnvironmentFocuses on building and managing provider networks, analyzing data, and strategic planningCenters on maintaining provider relationships, communication, and resolving provider issues
Employer & Industry UsageUsed in health insurance companies, managed care organizations, and healthcare networksCommon in insurance companies, healthcare providers, and provider organizations

While both roles involve healthcare provider interactions, Entry Level Provider Network Development emphasizes network expansion and strategic planning, whereas Entry Level Provider Relations Coordinator focuses on maintaining provider relationships and communication. Both roles require similar educational backgrounds and are vital in healthcare organizations, but they differ in daily responsibilities and focus areas.

What jobs in the US pay 300,000 a year?

Entry level provider network development roles typically do not pay $300,000 annually; such high salaries are usually associated with senior executive, specialized medical, or highly experienced roles in healthcare administration or consulting. Most positions in provider network development start with lower compensation, but senior roles or those with extensive experience and certifications can reach or exceed this level.

What entry level jobs can you get with Network+?

Entry-level jobs that require Network+ certification include network technician, help desk technician, and IT support specialist. These roles involve troubleshooting network issues, maintaining hardware, and supporting users, often requiring knowledge of networking concepts, protocols, and tools like routers and switches.
What are the most commonly searched types of Provider Network Development jobs in California? The most popular types of Provider Network Development jobs in California are:
What cities in California are hiring for Entry Level Provider Network Development jobs? Cities in California with the most Entry Level Provider Network Development job openings:
Entry Level Provider Network Development jobs near you
Manager, Provider Network Operations

Manager, Provider Network Operations

Santa Clara Family Health Plan

San Jose, CA • On-site

$130K - $202K/yr

Full-time

Posted 8 days ago

Job description

Manager, Provider Network Operations
Salary Range: $130,622 - $202,465
The expected pay range is based on many factors, such as experience, education, and the market. The range is subject to change.
FLSA Status: Exempt
Department: Provider Network Operations
Reports To: Director, Provider Network Operations
GENERAL DESCRIPTION OF POSITION
The Manager, Provider Network Operations is responsible for providing day-to-day management and leadership of the Provider Network Operations team responsible for establishing and maintaining excellent relationships with SCFHP's provider network. This involves the development and execution of strategies related to communication, outreach, training, education, and service to the SCFHP provider network. The Manager designs and implements programs to build and nurture positive relationships with providers, staff and leadership of contracted health plans, physicians, hospitals, ancillary providers, IPAs, various types of health care facilities, and non-traditional medical providers. Responsibilities include conducting outreach to build relationships, conducting initial and subsequent provider orientations and ongoing training, troubleshooting concerns related to the provider's contract or operational issues, and implementing ongoing quality and service improvement initiatives in support of a positive member and provider experience. In addition to the externally, provider facing interactions, the Manager works collaboratively with the Director, Provider Network Operations, representing the department at management and cross-functional meetings and interfacing with other departments as necessary.
ESSENTIAL DUTIES AND RESPONSIBILITIES
To perform this job successfully, an individual must be able to perform each essential duty listed below satisfactorily.
  1. Develop and maintain in depth market knowledge regarding the provider community in Santa Clara County.
  2. Develop comprehensive training and resource materials related to SCFHP processes and procedures. This includes drafting and maintaining the SCFHP Provider Manual, website and provider portal content, provider newsletters, bulletins, tool kits, training materials, presentations, , and other planned and ad hoc provider communications.
  3. Create effective strategies for conducting provider outreach to provide timely information to the SCFHP provider network and to receive timely feedback from the network. Assure timely and appropriate responses to provider inquiries.
  4. Develop and conduct internal training across departments to assure appropriate knowledge and tools exist throughout the organization for servicing providers and understanding handoffs between departments.
  5. Represent the department at SCFHP committee meetings and workgroups. Act as a subject matter expert for cross-functional activities. Be the voice of the provider community at SCFHP, communicating the needs of the provider network as they relate to administrative processes, policies and performance.
  6. Manage the Physician Advisory Council, developing relationships with participants, organizing meetings and agendas, in compliance with the Brown Act. Keep topics engaging and relevant to current health plan priorities including SCFHP's Quality Improvement Health Equity Program, market trends and the regulatory environment.
  7. Oversee the provider network associate's responsible for Joint Operations Committee meetings with providers, ensuring the agenda topics are timely, relevant, engaging, and actions are documented and receive appropriate follow through.
  8. Hire, manage and develop the provider network associate team to ensure effective communication strategies, including timely, documented efforts related to education of new and existing providers, questions from providers, interventions addressing concerns regarding quality of service impacting health plan members, and action plans that pertain to specific initiatives with the SCFHP provider network.
  9. Coordinate with Provider Network Operations management to create seamless hand offs related to onboarding, credentialing and recredentialing of providers, contract implementation, Service Level Agreement (SLA) monitoring, and ensuring accurate set up and configuration in SCFHP systems.
  10. Communicate clearly and concisely with providers at all levels, including administration, the provider office staff and relevant vendors; convey information to internal departments and organizational leadership when appropriate.
  11. Collaborate and work closely with the Manager, Provider Practice Transformation to conduct studies on operations, workflows, and fact gathering sessions with providers and transformation consultants to document, quantify, and specify quality improvement efforts. Work with providers and internal/external stakeholders to identify gaps and solutions to closing gaps between current and desired results.
  12. Manage compliance with applicable regulatory and reporting requirements; monitor new requirements and update required program documents accordingly.
  13. Identify issues, trends, and opportunities to improve efficiency and/or quality, or to better collaborate with departments and providers.
  14. Identify, research, and resolve program issues and escalate critical issues, problems, and delays to management and executive leadership, as needed.
  15. Participate in the implementation of new member benefits, including developing work plans to develop new provider relationships, as applicable.
  16. Conduct Provider Satisfaction Surveys, evaluate results and conclusions, and establish work plans for continuous improvement.
  17. Perform other related duties as required or assigned.

SUPERVISORY/MANAGEMENT RESPONSBILITIES
Carries out supervisory/management responsibilities in accordance with the organization's policies, procedures, applicable regulations and laws. Responsibilities include:
  1. Recruiting, interviewing, hiring, and training.
  2. Developing a high performing department culture and staff. This includes setting the standard for staff/peers and motivating employees to maximize organizational goals and objectives.
  3. Effectively assimilate, train and mentor staff and (when appropriate), cross train existing staff and initiate retraining. Coach to help increase skills, knowledge and (if applicable) improve performance.
  4. Set goals and plan, assign, and direct work consistent with said goals. Respond to employees' needs, ensure they have the necessary resources to do their work.
  5. Contribute to achieving organizational objectives in line with the organization's values by managing all aspects of performance management, including appraising performance, giving timely effective feedback, providing recognition, addressing complaints, resolving issues, and providing progressive discipline. Monitor work schedules and time off requests to ensure that adequate coverage is available for internal staff during regular business work hours.

REQUIREMENTS - Required (R) Desired (D)
The requirements listed below are representative of the knowledge, skill, and/or ability required or desired.
  1. Bachelor's Degree in Business, Healthcare Administration, or a related field, or equivalent experience, training or coursework. (R)
  2. Minimum six years of experience in a health care, managed care setting, provider organization or health policy organization requiring routine interaction with internal and external stakeholders and program management responsibilities. (R)
  3. Demonstrated achievement and progressive responsibilities in the area of provider network management. (R)
  4. Minimum three years direct supervisory/management experience. (R)
  5. Ability to establish and maintain effective internal and external working relationships to organize and lead cross-functional teams. (R)
  6. Experience developing training materials. (R)
  7. Ability to create and deliver effective presentations to diverse groups. (R)
  8. Ability to consistently meet compliance accuracy and timeline requirements by achieving regulatory standards. (R)
  9. Ability to organize, plan, direct and manage medium to large scale, complex, cross-functional, multi-departmental projects and/or programs to completion with minimal supervision; able to manage multiple concurrent initiatives and effectively prioritize in a dynamic environment. (R)
  10. The ability to track, gather and analyze large data sets and organize/write reports. (R)
  11. Strong project management experience. (R)
  12. Knowledge and experience with program evaluation. (R)
  13. Excellent communication skills including the ability to express oneself clearly and concisely when providing service to SCFHP internal departments, providers, and outside entities over the telephone, in person or in writing. (R)
  14. Strong writing skills and demonstrated proficiency in developing content related to provider manuals, training materials and web content. (R)
  15. Strong understanding of NCQA, HEDIS and government requirements. (R)
  16. Proficient in adapting to changing situations and efficiently alternating focus between tasks to support department operations as dictated by business needs. (R)
  17. Working knowledge and the ability to efficiently operate all applicable computer software including applications such as Outlook, Word and Excel. (R)
  18. Ability to assume responsibility and exercise good judgment when making decisions within the scope of the position. (R)
  19. Ability to maintain confidentiality. (R)
  20. Ability to comply with all SCFHP policies and procedures. (R)
  21. Ability to perform the job safely with respect to others, to property and to individual safety. (R)
  22. Maintenance of a valid California driver's license and acceptable driving record, in order to drive to and from off-site meetings or events, or the ability to use other means of transportation to attend off-site meetings or events. (R)

WORKING CONDITIONS
Generally, duties are primarily performed in an office environment while sitting or standing at a desk. Incumbents are subject to frequent contact with and interruptions by co-workers, supervisors, and plan members or providers in person, by telephone, and by work-related electronic communications.
PHYSICAL REQUIREMENTS
Incumbents must be able to perform the essential functions of this job, with or without reasonable accommodation:
  1. Mobility Requirements: regular bending at the waist, and reaching overhead, above the shoulders and horizontally, to retrieve and store files and supplies and sit or stand for extended periods of time; (R)
  2. Lifting Requirements: regularly lift and carry files, notebooks, and office supplies that may weigh up to 15 pounds; (R)
  3. Visual Requirements: ability to read information in printed materials and on a computer screen; perform close-up work; clarity of vision is required at 20 inches or less; (R)
  4. Dexterity Requirements: regular use of hands, wrists, and finger movements; ability to perform repetitive motion (keyboard); writing (note-taking); ability to operate a computer keyboard and other office equipment (R)
  5. Hearing/Talking Requirements: ability to hear normal speech, hear and talk to exchange information in person and on telephone; (R)
  6. Reasoning Requirements: ability to think and work effectively under pressure; ability to effectively serve customers; decision making, maintain a concentrated level of attention to information communicated in person and by telephone throughout a typical workday; attention to detail. (R)

ENVIRONMENTAL CONDITIONS
General office conditions. May be exposed to moderate noise levels.
EOE

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