Senior Provider Network Development Specialist

We have an opportunity to join the Alliance as a Senior Provider Network Development Specialist supporting the brand new team focused on recruitment and expansion of our provider network for the Provider Services Department.  This position has regular/ frequent in-community requirements within the Alliance service counties including Santa Cruz, San Benito, Mariposa, Merced, Monterey.

 

WHAT YOU'LL BE RESPONSIBLE FOR

Reporting to the Provider Network Development Manager, this position: 

• Conducts and coordinates professional level healthcare provider recruitment efforts and related activities
• Facilitates the onboarding process for new providers
• Performs research and analysis related to provider network requirements, to develop provider recruitment strategies, and to identify opportunities for network expansion
• Assists the Provider Network Development Manager with Unit administration and special projects
• Performs other duties as assigned

 

ABOUT THE TEAM

From outreach and recruitment to educating and supporting our Provider Network, we're the team who establishes, builds, and maintains our positive working relationship with local providers. 

 

THE IDEAL CANDIDATE 

• Experienced in professional healthcare provider recruitment and contracting across various specialties
• Proficient in developing recruitment strategies and conducting outreach to new provider types, including non-traditional providers (mental health, doulas, etc.)
• Skilled in negotiating contracts with a focus on high-quality care and cost-effectiveness
• Capable of mentoring and coaching other specialists, serving as a subject matter expert
• Proficient in conducting market research to identify network gaps and expansion opportunities
• Able to analyze provider data and performance metrics to support network development strategies

 

WHAT YOU'LL NEED TO BE SUCCESSFUL

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

• Knowledge of:
• Thorough knowledge of the principles and practices of healthcare provider recruitment
• Provider contract negotiation and contract management principles, including reimbursement rates, service level agreements, and performance metrics
• Healthcare delivery systems, including hospitals, clinics, and other healthcare provider types
• Health care industry and managed care concepts
• Research, analysis, and reporting methods
• Working knowledge of the California Medi-Cal program and related regulations
• Ability to:
  • Act as a technical resource for Provider Network Development Specialists
  • Develop and implement effective provider recruitment strategies
  • Conduct provider outreach in a positive and professional manner that builds relationships and ability to take initiative to follow up with prospective providers as appropriate
  • Identify providers’ priorities and how the Alliance can meet providers’ needs
• Education and Experience:
  • Bachelor’s degree in Healthcare Administration, Business Administration, Social Science, or a related field
  • Minimum of 5 years of experience in a managed care environment performing provider network development, provider relations and/or provider contracting activities, which included  a minimum of 3 years of experience performing provider recruitment activities and some experience working with Medi-Cal
  • Master’s degree may substitute for two years of the required experience; or an equivalent combination of education and experience may be qualifying

 

OTHER INFORMATION

• We are in a hybrid work environment and we anticipate that the interview process will take place remotely via Microsoft Teams.
• While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected.
• In-office or in-community presence may be required for some positions and 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).

 

 

OUR BENEFITS

• Medical, Dental and Vision Plans
• Ample Paid Time Off
• 12 Paid Holidays per year
• 401(a) Retirement Plan
• 457 Deferred Compensation Plan
• Robust Health and Wellness Program
• Onsite EV Charging Stations
• And many more

---

ABOUT US

We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us. 

The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer

Join us at Central California Alliance for Health (the Alliance) is an award-winning regional Medi-Cal managed care plan that provides health insurance for children, adults, seniors and people with disabilities in Mariposa, Merced, San Benito and Santa Cruz counties. We currently serve more than 418,000 members. To learn more about us, take a look at our Fact Sheet.

---

At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.