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Provider Relations Manager Jobs in California (NOW HIRING)

Cavallopoint

Guest Relations Manager

Sausalito, CA · On-site

$65 - $75/hr

Guest Relations Manager We are looking for a Guest Relations Manager to act as an 'Ambassador' for the Resort providing guest recognition pre arrival, throughout the guest stay, and after departure.

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All JobsProvider Relations JobsProvider Relations Manager JobsProvider Relations Manager Jobs in California

Provider Relations Manager information

See California salary details

$34K

$77.1K

$132.2K

How much do provider relations manager jobs pay per year?

As of Sep 4, 2026, the average yearly pay for provider relations manager in California is $77,061.00, according to ZipRecruiter salary data. Most workers in this role earn between $45,400.00 and $98,700.00 per year, depending on experience, location, and employer.

What does a provider relations manager do?

A Provider Relations Manager serves as the main point of contact between healthcare providers, such as doctors or hospitals, and insurance companies or healthcare organizations. They work to build and maintain strong relationships, address concerns, and ensure effective communication. Their responsibilities include negotiating contracts, resolving issues related to claims or services, and supporting providers with onboarding and training. Ultimately, they help ensure providers and organizations work together efficiently to deliver quality care to patients.

How does a provider relations manager typically collaborate with healthcare providers to resolve issues or concerns?

Provider Relations Managers frequently serve as the main point of contact between healthcare organizations and their provider networks. They collaborate closely with providers to address operational concerns, such as claims processing, contract questions, or compliance matters. This often involves organizing regular meetings, conducting site visits, and facilitating communications between internal teams and providers to ensure high service levels and mutual understanding. Strong relationship-building and problem-solving skills are essential for success in this role.

What are the key skills and qualifications needed to thrive as a provider relations manager, and why are they important?

To thrive as a Provider Relations Manager, you need a strong background in healthcare administration, contract negotiation, and provider network management, often supported by a bachelor’s degree in health administration or a related field. Familiarity with healthcare claims systems, provider databases, and regulatory compliance tools is typically required. Exceptional interpersonal skills, problem-solving abilities, and effective communication help build and maintain strong provider partnerships. These competencies ensure successful collaboration, network expansion, and the delivery of high-quality healthcare services.

What is the difference between Provider Relations Manager vs Provider Relations Specialist?

AspectProvider Relations ManagerProvider Relations Specialist
CredentialsBachelor's degree, experience in healthcare or insuranceSimilar credentials, often entry to mid-level experience
Work EnvironmentSupervisory roles, strategic planning, team managementOperational support, provider communication, data entry
Employer & Industry UsageHealth insurance companies, healthcare providersHealth plans, insurance firms, healthcare organizations
Search & Comparison IntentHigher-level responsibilities, management rolesOperational tasks, provider communication roles

The Provider Relations Manager typically oversees provider relations teams, focusing on strategy and relationship management. The Provider Relations Specialist handles day-to-day provider communication and support. Both roles require healthcare knowledge, but the manager position involves more leadership and strategic planning.

What are the most commonly searched types of Provider Relations jobs in California?

The most popular types of Provider Relations jobs in California are:

What are popular job titles related to Provider Relations Manager jobs in California?

For Provider Relations Manager jobs in California, the most frequently searched job titles are:

What job categories do people searching Provider Relations Manager jobs in California look for?

The top searched job categories for Provider Relations Manager jobs in California are:

What cities in California are hiring for Provider Relations Manager jobs?

Cities in California with the most Provider Relations Manager job openings:

What are popular job titles related to Provider Relations Manager jobs in CA?

For Provider Relations Manager jobs in CA, the most frequently searched job titles are:

Provider Relations Manager jobs near you
Infographic showing various Provider Relations Manager job openings in California as of August 2026, with employment types broken down into 85% Full Time, 14% Part Time, and 1% Contract. Highlights an 87% Physical, 2% Hybrid, and 11% Remote job distribution, with an average salary of $77,061 per year, or $37 per hour.

Claims & Provider Relations Oversight Specialist

Western Health Advantage

Sacramento, CA • On-site

Full-time

Re-posted 19 days ago

Job description

Claims & Provider Relations Oversight SpecialistWestern Health Advantage

Location: Sacramento, CA (Hybrid)
Salary: $70,304 – $85,000 annually
"Purpose that inspires. Impact that improves lives. Join us in building healthier communities." 
Western Health Advantage
 

Position Summary

Western Health Advantage is seeking a detail-oriented Claims & Provider Relations Oversight Specialist to support compliance and regulatory operations within our Claims and Provider Relations department. This role is responsible for ensuring departmental compliance with federal and state regulations, accreditation standards, and internal policies while serving as a key resource for audits, regulatory filings, reporting, and compliance initiatives.

The ideal candidate is organized, analytical, and collaborative, with experience in California managed care, claims and provider operations, and healthcare compliance.

What You'll Do
  • Coordinate compliance projects, regulatory filings, audits, and corrective action plans.
  • Develop, maintain, and update departmental policies and procedures.
  • Monitor compliance with federal and state regulations, NCQA standards, Knox-Keene requirements, HIPAA, and other applicable regulations.
  • Review regulatory guidance, legislation, and compliance communications, providing recommendations and responses as needed.
  • Support Annual Network Review (ANR), Geo Access, Provider Appointment Availability Surveys (PAAS), Provider Satisfaction Surveys (PSS), after-hours surveys, and related compliance activities.
  • Prepare compliance communications, provider education materials, newsletters, and handbook updates.
  • Monitor, audit, and report on department performance and compliance metrics.
  • Provide compliance education and training to department staff.
  • Oversee external vendors and medical groups to ensure timely and accurate claims processing and provider data maintenance.
  • Track corrective actions and analyze compliance trends to identify opportunities for improvement.
  • Maintain organized compliance documentation and regulatory records.
Qualifications
  • Bachelor's degree in Compliance, Healthcare Administration, Legal or Regulatory Affairs, or a related field.
  • Three (3) years of experience in healthcare compliance, governance, auditing, quality, accreditation, or regulatory operations.
  • Two (2) years of experience with a California-based HMO in Claims and/or Provider Relations.
  • One (1) year of experience implementing compliance programs involving NCQA, Knox-Keene, HIPAA, Covered California, PCI, or similar regulatory requirements.
  • Strong analytical, organizational, and communication skills.
  • Intermediate proficiency with Microsoft Office applications and experience with SmartSheet, SCAN/Cognos, or similar reporting tools.
  • Ability to manage multiple priorities while working independently and collaboratively.
What You'll Bring
  • Strong knowledge of healthcare regulatory and accreditation requirements.
  • Excellent project coordination and organizational skills.
  • Experience interpreting regulatory guidance and implementing compliance initiatives.
  • Ability to analyze data, identify compliance risks, and recommend solutions.
  • Strong written and verbal communication skills with the ability to collaborate across departments and with external partners.

Western Health Advantage is committed to providing equal employment opportunities to employees and applicants for employment on the basis of merit and without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, physical or mental disability, medical condition, genetic information, marital status, ancestry, military or veteran status, or any other basis made unlawful by federal or state law. (EOE)

Western Health Advantage values and supports the unique talents and strengths that each employee brings to our organization. Collaborating with the best and the brightest means a dynamic, fulfilling work experience for you—and excellent customer service for our members.


 

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