Provider Relations Specialist

2 weeks ago


Orange, California, United States Astiva Health, Inc Full time

Job Title: Provider Relations Coordinator (Bilingual - Korean, Vietnamese, or Chinese)

Target Compensation Range: $26.00/hour, depending on the relevant qualifications and experience.

About Us:

Astiva Health, Inc. is a leading healthcare organization focused on Medicare and HMO services. We are dedicated to providing comprehensive care that meets the diverse needs of our community, emphasizing accessibility, affordability, and quality in all our offerings. Our mission is to enhance healthcare delivery and positively impact the lives of our members.

POSITION OVERVIEW: The Provider Relations Coordinator plays a crucial role in delivering exceptional service to Independent Practice Associations (IPAs), Medical Groups, Management Services Organizations (MSOs), and various healthcare providers. This position is instrumental in the formulation, development, and execution of strategies aimed at enhancing service quality and provider satisfaction.

KEY RESPONSIBILITIES:

  • Foster and maintain strong professional relationships with contracted healthcare providers.
  • Respond promptly to inquiries from providers via calls, voicemails, and emails, collaborating with internal teams to resolve issues related to contracts, capitation, claims, referrals, and eligibility.
  • Verify provider information through direct communication to ensure the accuracy of the provider directory.
  • Manage daily requests for provider additions, modifications, and terminations from Medical Groups/IPAs, ensuring compliance with Health Plans SB137 regulations.
  • Support contracted providers with their portal accounts and provide virtual training as necessary.
  • Assist the Credentialing department by following up with providers to gather essential documentation.
  • Collaborate with the Sales and Marketing Department to coordinate and participate in promotional events.
  • Organize and schedule educational meetings with providers regarding initiatives such as annual wellness exams.
  • Perform additional duties as assigned.

QUALIFICATIONS:

  • High School diploma or GED is required.
  • A Bachelor's degree in Healthcare Administration, Finance, Business Administration, or a related field, or a combination of education and experience is preferred.
  • 2-3 years of experience in a provider relations capacity within a health plan, IPA, or medical group is highly desirable.
  • Comprehensive knowledge of Medicare, Medicaid, and HMO health plans is essential.
  • Exceptional critical thinking skills with the ability to independently investigate complex issues.
  • Bilingual proficiency in Korean, Vietnamese, or Chinese (both verbal and written) is required.

BENEFITS:

  • 401(k) Plan
  • Dental Coverage
  • Health Insurance
  • Life Insurance
  • Vision Coverage
  • Paid Time Off


  • Orange, California, United States Astiva Health, Inc Full time

    Job Title: Provider Relations Coordinator (Bilingual - Korean, Vietnamese, or Chinese)Target Compensation Range: $26.00/hour, depending on the relevant qualifications and experience.About Us:Astiva Health, Inc. is a leading healthcare organization dedicated to Medicare and HMO services. We focus on delivering inclusive care tailored to the diverse needs of...


  • Orange, California, United States Provider Solutions & Development Full time

    Position OverviewProvider Solutions & Development is seeking a dedicated Internal Medicine Specialist to become part of a thriving private practice. This role is based in a supportive environment that emphasizes teamwork and patient-centered care.Key ResponsibilitiesDeliver comprehensive outpatient care to a diverse patient population.Collaborate with a team...


  • Orange, California, United States Provider Solutions & Development Full time

    Exciting Career Opportunity for an Internal Medicine SpecialistBecome part of a thriving private medical practice.Collaborate with a dedicated team of five internal medicine and pulmonary specialists.Manage a diverse patient base with opportunities for expansion.Newly graduated professionals are welcome to apply.Achieve a balanced lifestyle while practicing...


  • Orange, California, United States Chapman University Full time

    Senior Employee Relations Specialist at Chapman University:The Senior Employee Relations Specialist is essential in providing support to the Employee Relations and Equal Opportunity divisions, primarily focusing on Employee Relations. This role encompasses addressing intricate issues, delivering guidance, and offering counseling to resolve employee inquiries...


  • Orange, California, United States Chapman University Full time

    Senior Employee Relations Specialist at Chapman University:The Senior Employee Relations Specialist is integral to the support of the Employee Relations and Equal Opportunity sectors, primarily concentrating on Employee Relations. This role encompasses the resolution of intricate issues, providing guidance, and offering counsel to address employee grievances...


  • Orange, California, United States Chapman University Full time

    Senior Employee Relations Specialist at Chapman University:The Senior Employee Relations Specialist is integral to the support of the Employee Relations and Equal Opportunity divisions, primarily focusing on Employee Relations. This role encompasses the resolution of intricate issues, providing guidance, and offering counseling to address employee grievances...


  • Orange, California, United States Pacific Coast Termite Full time

    Position Overview:We are seeking a Pest Control Specialist to play a vital role in our efforts to safeguard properties from termite infestations.Key Responsibilities:Analyzing termite inspection reportsImplementing treatment plans based on provided diagramsConducting wood treatment procedures and concrete injectionsUtilizing ladders for high-access...


  • Orange, California, United States Providence Service Full time

    Job SummaryWe are seeking a highly skilled Patient Experience Specialist RN to join our team at Providence Service. As a key member of our Patient Experience department, you will play a vital role in ensuring that our patients receive exceptional care and service.Key ResponsibilitiesCollaborate with caregivers and hospital departments to provide a...

  • Nurse Practitioner

    4 days ago


    Orange, California, United States Provider Solutions & Development Full time

    About the RoleWe are seeking a highly skilled and compassionate Nurse Practitioner to join our Obstetrics and Gynecology team at Providence St. Joseph Hospital in Orange, California.Key ResponsibilitiesProvide high-quality patient care in the OB Triage department, prioritizing care for pregnant patients.Work closely with a team of nurses and healthcare...


  • Orange, California, United States Provider Solutions & Development Full time

    Position OverviewProvider Solutions & Development is seeking a dedicated Internal Medicine Physician to become part of a thriving private practice. This opportunity is based in a well-established medical facility and offers a supportive environment for both new and experienced physicians.Key ResponsibilitiesProvide comprehensive outpatient care to a diverse...


  • Orange, California, United States Provider Solutions & Development Full time

    Position OverviewProvider Solutions & Development is actively seeking a dedicated Internal Medicine physician to become part of a thriving private practice in a vibrant community. This role offers an exceptional opportunity to work alongside a collaborative team of healthcare professionals.Key ResponsibilitiesDeliver high-quality outpatient care to a diverse...


  • Orange, California, United States Department of Industrial Relations Full time

    Job SummaryThe Department of Industrial Relations is seeking a highly skilled Management Services Coordinator to join our team. As a key member of our staff, you will be responsible for providing administrative support and coordinating public records requests in accordance with the Government Code.Key ResponsibilitiesCoordinate and respond to public records...


  • Orange, California, United States Provider Solutions & Development Full time

    Position OverviewProvider Solutions & Development is actively seeking a dedicated Internal Medicine Physician to enhance our dynamic practice. This role is based in a thriving healthcare environment, offering a unique opportunity to work alongside a team of experienced professionals.Key ResponsibilitiesDeliver high-quality outpatient care to a diverse...


  • Orange, California, United States Provider Solutions & Development Full time

    Job SummaryProvider Solutions & Development is seeking a highly skilled Physician Assistant or Nurse Practitioner to join our Primary Care team at our Orange, California location. As a key member of our team, you will be responsible for providing high-quality patient care and working collaboratively with our healthcare professionals to deliver exceptional...


  • Orange, California, United States Provider Solutions & Development Full time

    Job SummaryProvider Solutions & Development is seeking a highly skilled Physician Assistant or Nurse Practitioner to join our Primary Care team at our Orange, California location. As a key member of our team, you will be responsible for providing high-quality patient care and working collaboratively with our healthcare professionals to deliver exceptional...


  • Orange, California, United States AST Development Full time

    Position OverviewAST Development is seeking a dynamic and motivated Entry-Level Customer Service Associate to enhance our Marketing and Customer Service Division. This role is designed for individuals eager to gain comprehensive insights into various sectors of our organization through extensive training provided by our leadership team.As an Entry-Level...


  • Orange, California, United States ABM Industries Full time

    About the JobWe are seeking a highly motivated and detail-oriented Facilities Maintenance Specialist to join our team at ABM Industries. As a key member of our facilities team, you will be responsible for maintaining the cleanliness and organization of our buildings and facilities.Key ResponsibilitiesPerform daily cleaning and maintenance tasks, including...


  • Orange, California, United States Citi Staff Full time

    Job OverviewHuman Resources Specialist - Staffing SectorIn the staffing sector, client satisfaction is paramount. We seek an individual who comprehends the intricacies of this field and can adeptly manage its challenges.The Human Resources Specialist remains informed about updates in employment legislation and organizational policies, procedures, and...

  • Senior Legal Clerk

    4 days ago


    Orange, California, United States Department of Industrial Relations Full time

    Job SummaryThe Department of Industrial Relations is seeking a highly skilled and detail-oriented Senior Legal Typist to join our team. As a Senior Legal Typist, you will play a critical role in supporting the Division of Workers' Compensation by preparing and serving orders, decisions, and correspondence, as well as providing secretarial and clerical...


  • Orange, California, United States Jobot Full time

    Exciting opportunity for a Financial Grants Specialist with a reputable non-profit organization About Us: We are dedicated to providing exceptional support for the homeless, emphasizing services that help families achieve stable housing. By evaluating families and individuals as they enter our care, we can pinpoint their specific needs and deliver immediate...