Provider Network Specialist jobs in Fontana, CA

Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 45 hospitals and has more than 300 outpatient locations in 14 states providing more than 2.6 million patient visits annually. It is one of the nation's leading health systems with nearly 50,000 employees and physicians. Fourteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!

Prime Healthcare offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs.

Our Total Rewards package includes, but is not limited to:

Paid Time Off
• 401K retirement plan
• Outstanding Medical
• Dental
• Vision Coverage
• Tuition Reimbursement
• Many more Voluntary Benefit Options!

Benefits may vary based on employment status, i.e. full-time, part-time, per diem or temporary.

We are an Equal Opportunity Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation, or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf

The Director of Network Development and Provider Relations would be responsible for provider communications and outreach :

• Assessing opportunities for policy and procedure development.
• Managing the provider directory, executing contracts to address network gaps.
• Working with local and regional leadership to assess network opportunities.
• Establishing regular communications with providers on a quarterly basis.
• Holding town halls or educational sessions for providers and practice group manager.
• Managing the relationship with providers and assisting in resolution of issues in grievance committees.
• Identifying issues that require policy and procedure updates.
• Creating educational and outreach material content and working with marketing team to develop.
• Managing the provider facing platforms (EHP website and create quarterly communications/education).

This position is accountable for ensuring effective implementation of new as well as renewed contracts through communication and coordination with other functional areas.

#LI-RK1

Required Qualifications:

1. Bachelor's degree or equivalent experience in Business Administration, Healthcare Administration, or related field.
2. 10 years of experience in customer service and provider relations in a health care or managed care environment.
3. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.
4. Strong interpersonal and collaborative skills.
5. Demonstrated experience and knowledge of contracting requirements.
6. Experience working in a consensus building and matrix environments a plus.

Preferred Qualifications:

1. MBA/MHA preferred.
2. Lean Program experience
3. Previous health plan and provider representative experience.

A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $99,840.00 to $133,120.00 on an annualized basis. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.