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Entry Level Provider Network Development Jobs in California

Reporting: recurring and ad hoc development * Data quality monitoring, reconciliations, audits, issue resolution * Healthcare provider network knowledge, PCP assignment, GEO coding * Application ...

In this role, you will provide network engineering support to NIWC Pacific Code 55111 to fulfill ... development, with a primary mission of aerial refueling and a secondary capability to provide ...

New

Manages the relationship and performance of the service provider network through direct interaction ... Plus, we offer learning and development opportunities to help our associates grow their skills and ...

In this role, you will provide network engineering support to NIWC Pacific Code 55111 to fulfill ... development, with a primary mission of aerial refueling and a secondary capability to provide ...

Network Engineer

San Diego, CA · On-site

$91K - $130K/yr

In this role, you will provide network engineering support to NIWC Pacific Code 55111 to fulfill ... development, with a primary mission of aerial refueling and a secondary capability to provide ...

Network Engineer

San Diego, CA · On-site

$91K - $130K/yr

In this role, you will provide network engineering support to NIWC Pacific Code 55111 to fulfill ... development, with a primary mission of aerial refueling and a secondary capability to provide ...

GTS provides solutions to achieve Breakthrough Performance through the intelligent use of ... Coordinating a team of 2-3 entry-level and mid-level engineers or analysts, apply independent ...

GTS provides solutions to achieve Breakthrough Performance through the intelligent use of ... Coordinating a team of 2-3 entry-level and mid-level engineers or analysts, apply independent ...

Showing results 41-60

Entry Level Provider Network Development information

What is an entry level provider network development?

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?

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:

Provider Relations Representative

UnitedHealth Group

San Bernardino, CA • On-site

$60K - $90K/yr

Full-time

Retirement

Posted 12 days ago


UnitedHealth Group rating

7.6

Company rating: 7.6 out of 10

Based on 146 frontline employees who took The Breakroom Quiz

188th of 887 rated healthcare providers


Job description

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.

As a Provider Relations Representative at Optum, you will act as a direct interface between Optum and the affiliated physicians in Optum's Independent Physician Association (IPA) network and support their operations and performance success.  This position provides continuous education, support, training and troubleshooting to physicians and their staff.

This position will require regular travel across Riverside County.

Primary Responsibilities:

  • Serve as single-point-of-contact to the physician network and is an accountable owner, responsive to physician needs. Knowledgeable about incentive programs, contract reimbursement, Optum's internal processes and priorities, and other Optum initiatives, as applicable
  • Monitors performance of assigned PCPs, identifies low performing PCPs and works with IPA leadership to develop action plan for specific metrics needing improvement. Works with office to effectuate action plans and monitors progress
  • Intervenes and escalate issues as appropriate
  • Maintains awareness of providers interested in further engaging with Optum on new business opportunities (contracts and business combinations), and on shifting market/competitive dynamics that would impact the IPA
  • Works collaboratively with offices and Optum growth team to drive membership growth and retention
  • Responds timely (within one business day) to provider issues, works with other groups/central departments to resolve issues and updates providers and office staff regularly through to resolution
  • Build collaborative relationships with IPA physicians and their office staff

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

  • 2 years of health care/managed care experience
  • 2 years of provider relations and/or provider network experience
  • Intermediate level of proficiency in claims processing and issue resolution
  • Proficiency with Microsoft Office Suite
  • Able and willing to travel 50% within assigned territory

Preferred Qualification:

  • Provider recruitment and contracting experience

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $90,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.    

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.  

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. 


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