Business Development Specialist ,- Provider - Relations Sales Professional Nurse PartnersBusiness Development Specialist ,- Provider - Relations SalesYorba Linda, CAFull timeThe Provider Relations Outreach Associate is responsible for marketing and education in the community providing coordination of community resources for clients served by Professional Nurse Partners and Integrative Health Management with a clear customer focus. Our life care management and wellness program sales representatives present the benefits and appropriate use of home care to physicians, hospital case managers, skilled nursing facility social services and other healthcare professionals.
Provider Relations and Contract Operations Associate, 30hrs Beth Israel Lahey HealthProvider Relations and Contract Operations Associate, 30hrsBaldwin Park, CaliforniaSupports Provider Relations and Contract Operations Specialist with enrolling physicians in the health plans under contract with the IPA and Network, including but not limited to distribution and collection of enrollment materials, interacting with the physicians and/or office staff and health plan credentialing staff, tracking enrollment, tracking IPA membership fees, and reviewing the accuracy of materials submitted to health plans and Network. Prepares for and coordinates key organizational meetings including: quarterly New Physician Orientation Meetings, Annual Practice Manager Meetings, Annual Physician Membership Meetings, and other meetings as assigned.
Provider Relations Lead - So Cal SCAN Health PlanProvider Relations Lead - So CalLong Beach, CaliforniaThis individual proactively anticipates provider needs, responds promptly to inquiries, and takes full ownership and accountability for resolving issues and driving results; applies critical thinking and intellectual curiosity to deeply understand provider organizations, exhibiting abilities with navigating complex organizations and building trust with a variety of stakeholders; demonstrates both breadth and depth of knowledge—capable of engaging across a wide range of topics and diving deep to resolve complex challenges as needed; effectively project manage provider needs and initiatives, presenting confidently to diverse provider audiences and tailoring communication strategies to the in different nuanced scenarios order to develop actionable solutions. 5 years of relevant healthcare or Medicare Advantage experience; experience working with provider organizations or healthcare operations; experience with delegated or risk-based provider arrangements; experience supporting provider performance improvement initiatives; experience presenting data to provider or operational audiences.
Provider Relations Intake Specialist University of CaliforniaProvider Relations Intake SpecialistLos Angeles, CA$31.99–$50.24 / hourAs a condition of employment, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer. This role coordinates and tracks provider additions, changes, and terminations while supporting accurate provider data, health plan submissions, and timely processing across the provider lifecycle.
Provider Contract Negotiation Manager CVS Health CorpProvider Contract Negotiation ManagerCARemote$60,300–$132,600 / yearWorking knowledge of Aetna systems and tools, including Smart Front End, ASD, HRP, MedCompass, and RUMBA applications (EPDB, EWMP, Rate Inquiry, and Contract Inquiry). Develop, maintain, and enhance working relationships with physicians/providers and local network and patient management teams in the markets within Aetna.
Director, Contracts SCAN Health PlanDirector, ContractsLong Beach, California$168,000–$215,000 / yearHowever, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. The Director of Contracts is a strategic leader within SCAN’s Network Management team, responsible for developing and managing high-impact provider partnerships including delegated medical groups, IPAs, health systems, and hospitals.
VP of Operations Impresiv HealthVP of OperationsHuntington Beach, CA$165,000–$180,000 / yearProvide executive oversight of: Claims administration and payment operations, Member services and customer experience, Provider services and provider relations, Enrollment, eligibility, and premium billing, Utilization management support operations, Care coordination support services, Appeals and grievances, Credentialing and provider data management, Delegation oversight and vendor management, and Operational compliance and audit readiness. This position provides strategic direction and operational leadership to support exceptional service delivery, regulatory compliance, quality outcomes, positive member and provider experiences, and responsible financial management.
Provider Relations Specialist Nexus HR ServicesProvider Relations SpecialistEl Monte, CA$30–$40 / hourThe Provider Relations Specialist supports the Network Development department by developing and managing provider relationships and contracting, gaps in care (HEDIS) efforts with providers, group practices, and ancillary providers based on network adequacy and client market needs. This 1099/Independent role focuses on building strong provider relationships, negotiating contracts, going over HEDIS measures, and maintaining an effective healthcare provider network.
Senior Physician Liaison Clarify Health Solutions IncSenior Physician LiaisonCA$135,000–$160,000 / yearWith industry-leading statistical modeling and machine learning, Clarify Health harnesses the power of the most comprehensive longitudinal dataset in the US by linking clinical, claims, prescription, lab, and social determinants of health data across over 300 million lives. 5+ years of healthcare experience with at least 3 years in a direct provider-facing role (physician liaison, provider relations, pharma sales, practice transformation, or network management).
Provider Relationship Account Manager Senior Elevance HealthProvider Relationship Account Manager SeniorCosta Mesa, CA$96,416–$150,912 / yearThe Provider Relationship Account Manager Senior serves as a central point of coordination among Provider Network Management, Regulatory Affairs, Compliance, Case Management, Member Services, Provider Operations, regulators, providers, and other internal and external stakeholders. Serves as a knowledge and resource expert regarding complex provider issues impacting provider satisfaction; research, analyzes, and coordinates prompt resolution to complex provider issues and appeals through direct contact with providers and internal matrixed partners.
Provider Directory Data Assurance Analyst MedPOINT ManagementProvider Directory Data Assurance AnalystSherman Oaks, CAFull timeMedPOINT Management is a leading Independent Practice Association (IPA) management company based in Sherman Oaks, CA, dedicated to supporting high-quality, cost-effective healthcare delivery across Southern California. Employees thrive here thanks to a collaborative culture, meaningful work, and the opportunity to make a lasting difference in the lives of patients and providers alike.
Provider Directory Data Assurance Analyst ADPProvider Directory Data Assurance AnalystSherman Oaks, CaliforniaAbout Us: MedPOINT Management is a leading Independent Practice Association (IPA) management company based in Sherman Oaks, CA, dedicated to supporting high-quality, cost-effective healthcare delivery across Southern California. Employees thrive here thanks to a collaborative culture, meaningful work, and the opportunity to make a lasting difference in the lives of patients and providers alike.
Account Manager ACOs & Medicare Supplement MediGap Health Plans Ceresti Health IncAccount Manager ACOs & Medicare Supplement MediGap Health PlansCAYou will serve as the primary partner for ACOs and Medicare Supplement carriers partnering with Ceresti - helping both ACOs and MediGap carriers strategically leverage the GUIDE Model to impact one of the costliest, most unmanaged cohorts in their populations. MediGapcarriers bring a different but equally complex dynamic - product and actuarial teams evaluating clinical value, compliance teams navigating CMS requirements, and member services teams that need seamless integration with GUIDE Model workflows.
Provider Growth and Relationship Lead Amae HealthProvider Growth and Relationship LeadLos Angeles, California$67,500–$94,500 / yearYou'll build and manage a network of hospital systems, EDs, discharge planners, and outpatient providers to create a consistent pipeline of qualified referrals — and you'll personally walk many of those patients through the warm handoff into care, meeting them in the hospital, at home, or in the community to make sure the transition actually holds. Alongside care delivery, we are building the science and technology the field has long lacked—proprietary clinical protocols, novel measurement, and an AI-driven data platform designed for severe mental illness.
NewAnalyst, Account Manager CVS Health CorpAnalyst, Account ManagerCA$43,888–$76,500 / yearOperating within a highly customized service environment supporting globally distributed populations, the Account Manager partners closely with client contacts, internal business partners, and external vendors to resolve complex issues, drive service improvements, and execute account strategies aligned with client objectives and organizational goals. This role serves as the primary point of contact for a defined group of client stakeholders within designated geographic regions, providing strategic account management, operational support, and consultative guidance to ensure a high level of service and client satisfaction.
Senior Staff Software Engineer SCAN Health PlanSenior Staff Software EngineerLong Beach, CaliforniaAI Driven Development: Thorough knowledge and experience implementing healthplan/payor use cases covered for by popular AI/ML assist models such as ChatGPT (GPT-4X), Claude 3.5, and the native API for integration; Hands on experience using Coding Assistants such as GitHub Copilot, Cursor, Claude Code, and frameworks/platforms such as Microsoft Copilot. Expert in creating High-Level and Low-Level Design (HLD/LLD), sequence diagrams, architecture flows for enterprise applications, and using relational database management systems such as SQL Server, non-relational database MongoDB, Cosmos DB.
NewSr. VoIP Call Manager Vision Information Technology Consultants LLCSr. VoIP Call ManagerLos Angeles, CAFull timeIf you are a results-driven IT leader, passionate about people, program excellence, government IT service management, and leading high-performing teams, we want you on our team. Key ResponsibilitiesSystem Management & InstallationInstall new software releases and system upgrades for Cisco Unified Communication Manager (UCM), evaluating and installing patches to maintain system stability.
NewPrincipal Product Manager, Directory The Council for Affordable Quality Healthcare IncPrincipal Product Manager, DirectoryCARemoteThe role engages health plan executives and buyers, provider organizations, and industry stakeholders, bringing fluency in buyer needs, procurement cycles, and directory operations, including network management, data intake, maintenance, outreach, and data verification, to improve how provider information is collected, governed, validated, and used across the healthcare ecosystem. Demonstrated experience managing provider directory data at scale, including data quality management; source-of-truth reconciliation across multiple contributing systems; provider verification of accuracy and primary source validation workflows; and identification, measurement, and remediation of directory data defects.
Manager, Strategy & Advisory Remote Trace3 IncManager, Strategy & Advisory RemoteIrvine, CARemote$170,000–$200,000 / yearHealthcare or related relevant operational/functional/data domain and/or technical experience, to drive Digital Transformation (secure, compliant Digital and Data/Analytics) engagement planning and execution across healthcare segments and across healthcare business units/functions, applications (traditional COTs and cloud-native solutions), and infrastructure environments (hybrid on-prem/cloud and multi-cloud). Work as part of a team of problem solvers, helping to solve complex business and technology issues from establishment of strategic objectives and key results for initiatives, development of and approach for programs in alignment with business goals, to leading the delivery of these business-driven technology engagements.
Client Partnerships Manager The Council for Affordable Quality Healthcare IncClient Partnerships ManagerCARemoteThe Client Partnerships Manager works closely with Product, Sales, Implementation, Operations, Analytics, Marketing, Finance and other internal partners to align resources around client priorities, address risks and create a consistent, high-quality client experience. As a member of the Client Partnerships organization, the Client Partnerships Manager will lead the development and execution of strategic account plans, drive solution adoption, monitor client health and strengthen relationships with operational and executive stakeholders.