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Entry Level Provider Network Development Jobs in California

Astiva Health

Contract Coordinator

Orange, CA

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

$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.

King Technologies, Inc.

Network Engineer II

San Diego, CA · On-site

$90K - $99K/yr

Brief Description Provide Engineer, Information Assurance (IA) and In-Service Engineer Agent (ISEA ... software development, integration, testing of hardware and software investment functions; and ...

King Technologies, Inc.

Network Engineer II

San Diego, CA · On-site

$90K - $99K/yr

Brief Description Provide Engineer, Information Assurance (IA) and In-Service Engineer Agent (ISEA ... software development, integration, testing of hardware and software investment functions; and ...

Regal Medical Group, Inc.

Network Coordinator

Orange, CA · On-site

$23 - $25/hr

... and development to include preparation of contract packets for recruitment projects. * Responsible to work with Network Managers and providers to obtain proper signatures and documentation to ...

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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 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 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 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
Associate Representative, Health Plan Provider Relations - Remote must reside in UT

Associate Representative, Health Plan Provider Relations - Remote must reside in UT

Molina Healthcare

Long Beach, CA • Remote

Full-time

Posted 21 days ago

Molina Healthcare rating

8.1

Company rating: 8.1 out of 10

Based on 193 frontline employees who took The Breakroom Quiz

133rd of 281 rated insurance

Job description

JOB DESCRIPTION Job Summary

*Must go to field as needed*

Provides entry level support for health plan provider relations activities.  Supports network development, network adequacy and provider training and education.  Serves as primary point of contact between the business and contracted providers within the Molina network.  Responsible for network management including provider education, communication, satisfaction, issue intake, access/availability and  ensuring knowledge of and compliance with Molina policies and procedures.

Essential Job Duties

Provides support for provider-related inquiries; successfully engages with providers and maintains provider satisfaction primarily for non-complex providers including but not limited to fee-for-service (FFS) and pay-for-performance (P4P) providers.
Receives, researches, and resolves provider inquiries such as claims, eligibility, and other inquiries, and represents as a liaison between the providers, medical groups and the health plan. 
Duties may include: price-specific services based on the plan's fee schedule, communicating and educating providers on important changes to regulations, procedures and access to information, assisting providers in dismissing or moving members incorrectly assigned to them, and educating providers to ensure appropriate dismissal letters are sent to Molina members.
Provides support to other members of the provider relations team in the field.
Documents provider requests in alignment with established provider relations departmental procedures. 
Facilitates provider relations mailbox response support.
Attends off-site meetings with medical groups and other providers as necessary.
Travels regularly throughout designated regions to meet targeted needs.
 

Required Qualifications

At least 1 year of customer service, provider services, or claims experience in a managed care or medical office setting, or equivalent combination of relevant education and experience.  
General understanding of the health care delivery system, including government-sponsored health plans.
Organizational skills and attention to detail.
Ability to manage multiple tasks and deadlines effectively.
Interpersonal skills, including ability to interface with providers and medical office staff.
Ability to work in a cross-functional highly matrixed organization.
Effective verbal and written communication skills.  
Microsoft Office suite and applicable software programs proficiency.
 

Preferred Qualifications

Familiarity with various managed health care provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including:  fee-for service (FFS), capitation and various forms of risk.
 

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

What Molina Healthcare employees say

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About Molina Healthcare

Sourced by ZipRecruiter

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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