Talent.com
Priority Family Care Center
Healthcare Network ManagerPriority Family Care Center • Los Angeles, CA, United States
Healthcare Network Manager

Healthcare Network Manager

Priority Family Care Center • Los Angeles, CA, United States
11 hours ago
Job type
  • Full-time
Job description

Healthcare Provider Network Liaison

To establish and maintain excellent relationships with the healthcare provider network in a specific geographic region, including healthcare practitioners, office staff, and administrators. Works closely to identify and resolve complex issues, provides education and staff training. Provides service and education via onsite visits and telephone. Assists providers with understanding managed care of California's policies and procedures and assists with resolving issues that arise.

Responsibilities:

  • Investigates and responds to provider concerns. Serves as a liaison between providers and SPN,IPA departments in responding to questions and resolving issues. Assists with research and disposition of provider appeals and grievances.
  • Identifies network gaps and performs recruitment to address community network needs.
  • Build and maintain relationships with all network providers.
  • Trains provider/ancillary offices via onsite visits and by telephone regarding SPN IPA policies, procedures, and available resources, referral, claim processing, portal access.
  • Creates educational materials and formal presentations.
  • Conducts and maintains office site visits to service providers with training and education, resolves issues, educates and interprets staff/providers on policies and procedures, collects credentialing information and reviews Healthcare Effectiveness Data and Information Set (HEDIS) information.
  • Educates providers on the use of IPA provider information forms. Follows up with providers on incomplete forms to obtain required information.
  • Resolves complex authorization or claims issues. Identify potential system issues, collaborate with affected departments to ensure resolution.
  • Conducts, quarterly utilization management meeting, annual and ad hoc, and provider/member surveys. Coordinates, attends, and participates in various meetings both on and off-site as assigned.
  • Creates Corrective Action Plans (CAPS) for provider sites that did not meet standards. Monitors compliance with CAP.
  • Uses databases and tracking systems to document and retrieve information and run reports.
  • May be required to report on major points, resolved and pending action items.
  • Required to work with minimal supervision.
  • Other duties as assigned.

Qualifications

Education and Experience:

  • Bachelor's degree in health care administration, business, or public relations preferred, or equivalent combination of education and experience; prior experience with physician offices or managed care, IPA or health insurance environment preferred.

Requirement:

  • Excellent oral and written communication and presentation skills.
  • Excellent organizational, prioritizing, and multi-tasking skills required.
  • Ability to use good judgment in making decisions within scope of authority and handle sensitive issues with tact and diplomacy.
  • Proficient in Microsoft Office (Word, PowerPoint, Excel).
  • Ability to use a variety of databases for research and entry of information.
  • Valid California driver's license and proof of current automobile.
  • Must be able to work in a fast-paced environment and maintain courtesy and composure.
  • Ability to function effectively with frequent interruptions.

Work Environment And Physical Demands:

Hours:

Mon Friday 40 hrs. a week

Paid:

Holidays, Vacation and Sick DaysAt least 50% of work time is spent driving and more than 30% of work time is spent in office. Ability to lift, carry or move objects of varying size, weighing up to 15 lbs.Compensation between $25 and $30/hr x 40 hours a week.Medical, Dental and Vision insurance available after 90 days. 401K after 6 months.

Create a job alert for this search

Healthcare Network Manager • Los Angeles, CA, United States

Similar jobs

Network IT Manager

KBREl Segundo, CA, United States
Full-time

KBR's National Security Solutions team provides high-end engineering and advanced technology solutions to our customers in the intelligence and national security communities.In this position, your ... Show more

 • Promoted

Manager, Media Relations - Health and Wellness

HerbalifeLos Angeles, CA, United States
Full-time

Herbalife is seeking a Media Relations Manager who is passionate about storytelling, thinks strategically, has strong media relations skills and has a proven track record of securing media coverage... Show more

 • Promoted

Senior Project Manager - Healthcare

StantecLos Angeles, CA, United States
Full-time

Stantec's Buildings team is on a mission to become the world's leading integrated design practice.Our architects, engineers, interior designers, consultants, sustainability specialists, and technol... Show more

 • Promoted

Project Manager ( Healthcare)

ClaycoLos Angeles, CA, United States
Full-time

Clayco is a full-service, turnkey real estate development, master planning, architecture, engineering, and construction firm that safely delivers clients across North America the highest quality so... Show more

 • Promoted

Wealth Relationship Manager SAFE ACT - La Canada

CitigroupLa Canada Flintridge, CA, United States
Full-time

Wealth Relationship Manager Safe Act - La Canada.Analyst Safe Act is a seasoned professional role.Applies in-depth disciplinary knowledge, contributing to the development of new techniques and the ... Show more

 • Promoted

Assistant Manager

El Pollo LocoCarson, CA, United States
Full-time

Have you ever envisioned leading a team to success or dared to help manage a million-dollar business? Well here's your opportunity to live the dream! Put your team-building skills to the test and b... Show more

 • Promoted

Project Manager - Networking and Infrastructure

Software Technology, Inc.Los Angeles, CA, United States
Full-time

Duration: Long Term Contract - 6 months to start with potential to extend through the end of the year.Location: Hybrid 8AM-5PM must be onsite every Friday for an in person meeting, will be requir... Show more

 • Promoted

Project Manager - Healthcare

HEDLos Angeles, CA, United States
Full-time

Experienced Project Manager for Healthcare Sector.Our Healthcare sector is looking to add an experienced team member with a minimum of 10 years in the A/E industry, post-graduation, to our group of... Show more

 • Promoted

Network Operations Section Manager, El Segundo, CA, Onsite

RaytheonEl Segundo, CA, United States
Full-time

Network Operations Section Manager.Senior Manager, Information Workplace Service M5.Raytheon Digital Technology Classified Information Systems.Onsite position - El Segundo, CA.Active US Top Secre... Show more

 • Promoted

Network Launch Support Coordinator

CACI InternationalEl Segundo, CA, United States
Full-time

Network Launch Support Coordinator.We are seeking a dynamic and experienced Project Manager to oversee and coordinate network support to satellite launch events and activities.The ideal candidate w... Show more

 • Promoted

Center Manager I

Exer Urgent CareBurbank, CA, United States
Temporary

Reports to: Regional Operations Director.Exer's mission is "creating convenient access to ER doctors in an affordable and caring environment.Exer can take care of about 80% of the procedures being ... Show more

 • Promoted

Network Administrator

TradeJobsWorkForce90021 Los Angeles, CA, US
Full-time

Network Administrator Job Duties: Assist in network design and implementation.Provide network support with ... Show more

 • Promoted

Healthcare IT PM (Cerner/Oracle Transformation)

T2GroupTorrance, CA, United States
Temporary

Join us for an unparalleled opportunity to spearhead an enterprise-wide application transformation at a prestigious top academic medical center.As the Program Manager, you will lead a groundbreakin... Show more

 • Promoted

Healthcare Network Manager

Priority Family Care CenterLos Angeles, CA, United States
Full-time

Healthcare Provider Network Liaison.To establish and maintain excellent relationships with the healthcare provider network in a specific geographic region, including healthcare practitioners, offic... Show more

 • Promoted

Team Manager

PaneraCarson, CA, United States
Full-time

Come join Panera Bread an award-winning leader in the restaurant industry and employer of choice for 2022 and 2023!.A competitive hourly wage plus tips!.A comprehensive benefit package including he... Show more

 • Promoted

Nursing Manager

APLA HealthLos Angeles, CA, United States
Full-time

APLA Health Center Mid Wilshire - Los Angeles, CA 90036.Salary/year Position Type Full Time Job Shift Day: 8am - 5pm Education Level BSN - Bachelor of Science - Nursing Travel Percentage None Categ... Show more

 • Promoted

TikTok Shop - Creator Manager, Health

TikTokLos Angeles, CA, United States
Full-time

TikTok Shop - Creator Manager, Health.Team Overview You've seen the virality and impact of #TikTokMadeMeBuyIt.Come join the team that is helping scale that phenomenon, and pioneer Content & Creator... Show more

 • Promoted

(Future Opportunities) Remote Healthcare Provider Network Contractor

EWINGSLos Angeles, CA, United States
Remote
Full-time

Future Opportunities Healthcare Provider Network Contractor.EWINGS is seeking to build our talent network with Network Contractor professionals that have a minimum of 5+ years of experience develop... Show more

 • Promoted

Team Manager

Panera BreadLong Beach, CA, United States
Full-time

At Panera, our leaders are celebrated for bringing out the best in their teams.Enjoy great perks, a welcoming culture, and the opportunity to make a real impactevery day.Get ready to rise and come ... Show more

 • Promoted

IT Manager

Integrated Polymer SolutionsLong Beach, CA, United States
Permanent

Rubbercraft is seeking an IT Manager to lead the implementation of our new Epicor ERP system and serve as a strategic technology partner to the business.This role will initially focus on delivering... Show more