Network Management Specialist

6 days ago


Orange, California, United States Alignment Healthcare Full time

**Job Title:** Network Management Specialist

About Us:

Alignment Healthcare is a healthcare company that revolutionizes health care for seniors by leveraging its world-class technology platform, innovative care delivery models, deep physician partnerships, and serving heart culture.

Job Description:

We are seeking a skilled Network Management Specialist to assist in building and maintaining high-performance provider networks. This role involves identifying opportunities to contract with providers and improve contractual performance.

The successful candidate will work closely with other departments to enhance the contracted provider experience consistent with our mission statement and values.

Main Responsibilities:

  • Recruit new providers and prepare supporting documentation for contracting.
  • Negotiate and implement contracts for physicians and ancillary providers.
  • Serve as a technical resource on provider relations issues and interact with internal and external customers professionally.
  • Maintain internal awareness of network changes by issuing timely and accurate provider update communications.
  • Ensure overall compliance by responding to grievances/appeals and adhering to regulatory and departmental Policy and Procedure guidelines.

Requirements:

  • Minimum 5+ years' experience in provider relations/contracting with an HMO or IPA, medical group, or institutional provider required.
  • Bachelor's Degree preferred.

Additional Skills:

  • Strong analytic, quantitative, and problem-solving skills required.
  • Strong verbal and written communication skills required.
  • Proficiency in MS Word and Excel required; Access database proficiency preferred.

Work Environment:

  • Office Hours: Monday-Friday, 8am to 5pm. Extended work hours, as needed.
  • 20% travel may be required at times.

Salary Range:$70,000 - $75,000 annually.



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