Provider Network Specialist jobs in Santa Cruz, CA

Provider Network Specialist coordinates and evaluates the contracts of a healthcare provider network. Participates in the negotiation of contracts and prepares reports and analysis of contract details and statistics. Being a Provider Network Specialist distributes contract information, status updates, and other information within the organization. Requires a bachelor's degree. Additionally, Provider Network Specialist typically reports to a manager or head of a unit/department. The Provider Network Specialist gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Provider Network Specialist typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)

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Provider Network Development Manager
  • Central California Alliance for Health (Remote)
  • Santa Cruz, CA FULL_TIME
  •  

    We have an opportunity to join the Alliance as the Provider Network Development Manager within the Provider Services Department, leading the Provider Network Development team. This position will require regular and ongoing travel within Alliance service counties. 

     

    ABOUT THE JOB 

    The Provider Network Development Manager is a new role at the Alliance and will lead a team focused on ongoing recruitment and development of a robust provider network. With upcoming changes in the management of Behavioral Health services as well as standing up a Medicare D-SNP program beginning in 2026, the Provider Network Development Manager will lead the strategic recruitment efforts in building an integral provider network to support those programs. This role will work cross-functionally, collaborating with the Alliance’s Provider Relations and Contracts teams and other departments within the organization.  

     

    WHAT YOU'LL BE RESPONSIBLE FOR

    Reporting to the Provider Services Director, this position: 

    • Manages, plans, implements, and leads provider network development strategy
    • Manages and leads provider recruitment efforts
    • Manages and leads the Provider Network Development Unit, acts as a subject matter expert, provides guidance on unit functions and departmental operations
    • Manages, supervises, mentors, and trains assigned staff

     

    THE IDEAL CANDIDATE 

    • Understands network adequacy standards and has a proven track record of developing and executing effective provider recruitment strategies, particularly Medicare D-SNP and/or Behavioral Health providers 
    • Knowledge of providers within Alliance service counties (Mariposa, Merced, Monterey, San Benito, and/or Santa Cruz) 
    • Knowledge and understanding of provider contract negotiations 
    • Exceptional verbal communication skills, with strength in relationship building and influencing others through professional conversations 
    • Thrive in matrix management environment 
    • Adept at leading and collaborating with cross-functional teams 
    • Demonstrated ability to manage competing priorities, aligning them strategically with the company's objectives for optimal efficiency and success 
    • Seasoned leader, with demonstrated experience managing staff, including employee relations and fostering a positive workplace culture, coupled with a track record of driving staff development through mentorship, training, and performance management strategies 
    • Strength in developing efficient processes and workflows, knowing when and how to best implement process improvements initiatives  
    • Energized by regular-cadenced, face-to-face engagement with local providers to cultivate interest in contracting with the Alliance  

     

    WHAT YOU'LL NEED TO BE SUCCESSFUL

    To read the full position description, and list of requirements click here

    • Knowledge of:
      • The healthcare delivery systems, including hospitals, clinics, and other healthcare provider types
      • The California Medi-Cal program entitlement programs, and related regulations
      • The principles and practices of provider network evaluation, analysis, and reporting
      • Provider contract negotiation and contract management principles, including reimbursement rates, service level agreements, and performance metrics
      • Principles and practices of program and project management
    • Ability to:
      • Analyze provider network performance, identify gaps, and develop strategies for improvement
      • The development, implementation, and management of projects, programs, systems, policies, and procedures
      • Train, mentor, supervise, and evaluate the work of staff, promote an atmosphere of teamwork and cooperations, and motivate staff to achieve goals and objectives
      • Provide leadership, facilitate meetings, and present information, data, and results in a clear and understandable manner utilizing methods appropriate to various forums
      • Present strategic information, data and results in a clear and understandable manner utilizing methods appropriate to various forums
    • Education and Experience:
      • Bachelor’s degree in Healthcare Administration, Business Administration, Social Science, or a related field
      • A minimum of six years of experience in managed care, which included a minimum of three years of supervisory or management level experience related to provider network development, provider relations, and/or provider contract negotiations (a Master’s degree may substitute for two years of the general managed care experience); or an equivalent combination of education and experience may be qualifying

     

    OTHER DETAILS

    • While this position is connected to one of our Alliance offices, we are in hybrid remote/in-office work environment right now and we anticipate that the interview process will take place remotely.
    • Our Alliance office locations have officially re-opened after the pandemic and while some employees may work in full-time telecommute schedules, attendance at quarterly company-wide events or department meetings will be expected.
    • Based on the nature of work, this position will require regular travel within Alliance service counties, which is dependent on business need. Details about this can be reviewed during the interview process.

     

    The full compensation range for this position is listed by location below. 

    The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferrable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location).

  • 1 Month Ago

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Network Communication Systems Specialist
  • FresnoArmy Recruiting Cntr,
  • Capitola, CA FULL_TIME
  • NO EXPERIENCE NEEDED 25H – Network Communication Systems Specialist Job Description: As a Network Communications Systems Specialist, you’ll supervise network management functions while overseeing inte...
  • 20 Days Ago

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Network Communication Systems Specialist
  • FresnoArmyRecruiting™
  • Capitola, CA FULL_TIME
  • NO EXPERIENCE NEEDED25H – Network Communication Systems SpecialistJob Description:As a Network Communications Systems Specialist, you’ll supervise network management functions while overseeing integra...
  • 1 Day Ago

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Network Communication Systems Specialist
  • FresnoArmy RecruitingCenter,
  • Capitola, CA FULL_TIME
  • NO EXPERIENCE NEEDED25H – Network Communication Systems SpecialistJob Description:As a Network Communications Systems Specialist, you’ll supervise network management functions while overseeing integra...
  • 4 Days Ago

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Systems / Network Support Specialist
  • Cabrillo College
  • Aptos, CA FULL_TIME
  • Salary See Position Description Location Aptos/Watsonville, CA Job Type Full-time (100%) Job Number 2024-01796 Department/Division Information Technology Division Administrative Services Opening Date ...
  • 9 Days Ago

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Network Technician
  • University of California - Santa Cruz
  • Santa Cruz, CA FULL_TIME
  • JOB POSTING HOW TO APPLYFor full consideration, applicants should attach their resume and cover letter when applying for a job opening. For guidance related to the application process or if you are ex...
  • 1 Month Ago

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0 Provider Network Specialist jobs found in Santa Cruz, CA area

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Network Engineer
  • Diverse Lynx
  • Santa Clara, CA
  • Networking experience. Experience in handling Switches, Routers Worked in Data Center Experience in InfiniBand Experienc...
  • 3/29/2024 12:00:00 AM

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Network Engineer
  • Tata Consultancy Service Limited
  • Santa Clara, CA
  • Technical/Functional Skills: Switches, Router, DataCenter, Cisco LAN, Wireless, Aruba RelevantExperience: 8+ Years Exper...
  • 3/29/2024 12:00:00 AM

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Network Engineer
  • Omega Solutions
  • Santa Clara, CA
  • DAILY DUTIES / RESPONSIBILITIES: Participate in a team comprised of DHEC and solution implementation staff for Server Ho...
  • 3/28/2024 12:00:00 AM

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Junior Network Engineer
  • Robert Half
  • San Carlos, CA
  • Position: Junior Network Engineer Location: San Carlos (Hybrid) Duration: 6 months (initially) Overview: Robert Half is ...
  • 3/28/2024 12:00:00 AM

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Staff Network Engineer
  • Coupang
  • Mountain View, CA
  • We exist to wow our customers. We know we’re doing the right thing when we hear our customers say, “How did we ever live...
  • 3/28/2024 12:00:00 AM

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Network Engineer
  • Intelliswift Software
  • Sunnyvale, CA
  • Infrastructure Engineer 6 + months contract Onsite in Sunnyvale, CA. Strong network administration – switching and routi...
  • 3/25/2024 12:00:00 AM

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Network Engineer
  • First Point Group
  • Menlo Park, CA
  • The ideal candidate will be responsible for maintaining and intermittently improving our current network configuration a...
  • 3/25/2024 12:00:00 AM

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Senior Network Engineer
  • New Era Technology
  • Sunnyvale, CA
  • Role: Senior Network Engineer Location: Sunnyvale, CA New Era Technology is a global technology solutions provider with ...
  • 3/25/2024 12:00:00 AM

Santa Cruz (/ˈsæntə ˈkruːz/, Spanish: Holy Cross) is the county seat and largest city of Santa Cruz County, California. As of 2013 the U.S. Census Bureau estimated Santa Cruz's population at 62,864. Situated on the northern edge of Monterey Bay, about 32 mi (51 km) south of San Jose and 75 mi (120 km) south of San Francisco, the city is part of the 12-county San Jose-San Francisco-Oakland Combined Statistical Area. Santa Cruz is known for its moderate climate, natural environment, coastline, redwood forests, alternative community lifestyles, and socially liberal leanings. It is also home to th...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Network Specialist jobs
$65,424 to $97,839
Santa Cruz, California area prices
were up 2.5% from a year ago

Provider Network Specialist in Springfield, MO
As the liaison between provider and the health plan, candidates are tasked with ensuring improved revenue generated and patient quality score.
December 16, 2019
Provider Network Specialist in Stamford, CT
Previous experience in a network development, provider recruitment or provider contracting.
December 04, 2019
Provider Network Specialist in Fort Wayne, IN
In this position, employees will be expected to perform benefits analysis and create reports on provider performance to support the needs of the analysis found.
January 18, 2020