Provider Network Specialist jobs in Hayward, CA

Provider Network Specialist coordinates and evaluates the contracts of a healthcare provider network. Participates in the negotiation of contracts and prepares reports and analysis of contract details and statistics. Being a Provider Network Specialist distributes contract information, status updates, and other information within the organization. Requires a bachelor's degree. Additionally, Provider Network Specialist typically reports to a manager or head of a unit/department. The Provider Network Specialist gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Provider Network Specialist typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)

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Medi-Cal Provider Network Consultant IV
  • Kaiser Permanente
  • Oakland, CA OTHER
  • As a Provider Network Consultant, you will play a pivotal role in ensuring the strength and effectiveness of our Medicaid provider network. The Provider Network team is dedicated to managing relationships with providers and other external stakeholders, implementing new regulatory requirements, and optimizing network performance to ensure high-quality care delivery to our members. This position requires a blend of strategic thinking, relationship management, and analytical skills to drive continuous improvement in our provider network.


    Job Summary:

    Serves as a consultant to ensure the alignment, buy-in, and coordination of diverse stakeholders to drive the implementation of successful business initiatives and projects. Provides insight and supports the development and implementation of business initiatives, systems, and/or processes to a desired future state. Contributes to business strategy and supports organizational alignment and prioritization of business initiatives. Manages complex projects or project components, participates in and may lead change management activities, and performs data analyses in support of business initiatives. Supports vendor management as required. Monitors compliance of work activities by ensuring business plans and team members adhere to relevant policies and procedures.



    Essential Responsibilities:


    • Promotes learning in others by proactively providing and/or developing information, resources, advice, and expertise with coworkers and members; builds relationships with cross-functional/external stakeholders and customers. Listens to, seeks, and addresses performance feedback; proactively provides actionable feedback to others and to managers. Pursues self-development; creates and executes plans to capitalize on strengths and develop weaknesses; leads by influencing others through technical explanations and examples and provides options and recommendations. Adopts new responsibilities; adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; champions change and helps others adapt to new tasks and processes. Facilitates team collaboration to support a business outcome.

    • Completes work assignments autonomously and supports business-specific projects by applying expertise in subject area and business knowledge to generate creative solutions; encourages team members to adapt to and follow all procedures and policies. Collaborates cross-functionally and/or externally to achieve effective business decisions; provides recommendations and solves complex problems; escalates high-priority issues or risks, as appropriate; monitors progress and results. Supports the development of work plans to meet business priorities and deadlines; identifies resources to accomplish priorities and deadlines. Identifies, speaks up, and capitalizes on improvement opportunities across teams; uses influence to guide others and engages stakeholders to achieve appropriate solutions.

    • Serves as a consultant to ensure the alignment, buy-in, and coordination of diverse stakeholders to drive the implementation of successful business initiatives and projects across one or more functional tracks or workstreams by identifying and ensuring representation and inclusion of appropriate stakeholders; building rapport and partnerships with stakeholder teams, third party vendors, and senior management; working with stakeholders to develop goals and set the prioritization of deliverables; discussing involvement of business processes (e.g. project change management, communication) and facilitating decisions necessary for the delivery of business initiatives; communicating tough issues to stakeholders while maintaining an independent perspective; and making formal presentations and providing reports to various senior level audiences.

    • Develops requirements for complex business, process, or system solutions within assigned business domain(s) by interfacing stakeholders and cross-functional teams as appropriate; leveraging multiple business requirements gathering methodologies to identify business, functional, and non-functional requirements; developing and documenting comprehensive business cases to assess the costs, benefits, and ROI of proposed solutions; and leading team members in the development process as appropriate.

    • Provides insight and supports the development and implementation of business initiatives, systems, and/or processes to a desired future state by maintaining a comprehensive understanding of how current processes impact business operations across multiple domains; mapping current state against future state processes; identifying the operational impact of requirements on upstream and downstream solution components; providing options and recommendations to management and business stakeholders on how to integrate solutions and deliverables with current systems and business processes across regions or domains; and identifying and validating value gaps and opportunities for process enhancements or efficiencies.

    • Contributes to business strategy and supports organizational alignment and prioritization of business initiatives by defining, developing, and evaluating performance metrics, standards, and methods to establish business success; collaborating with multiple stakeholders, often with competing/conflicting objectives, to ensure cohesive and reachable metrics; refining strategic plans and performance metrics as appropriate; and managing assigned initiatives or portfolio to ensure delivery of measurable results and alignment with strategic objectives.

    • Serves as a advocate of continuous learning and professional development by keeping abreast of industry practices, standards, and benchmarks; attending and participating in roadshows, conferences, and speaking events; contributing to the ongoing enhancement and innovation of consulting practices, standards, and methods across KP; serving as an advocate to ensure continuous learning and improvement is championed as a people strategy; providing training and guidance to stakeholders as appropriate; and providing ongoing coaching to build a continuous improvement mindset and build capabilities that drive results.

    • Manages complex projects or project components by coordinating stakeholder contacts; recommending or assigning team resources based on project needs and team member strengths; consulting in the development, analysis, and management of project plans; coordinating project schedules and resource forecasts; proactively monitoring and identifying project or business initiative risks, issues, and trigger events; developing mitigation plans and strategies; and resolving or escalating risks or issues as appropriate.

    • Participates in and may lead change management activities associated with business initiatives by engaging stakeholders to obtain support and buy in for changes; partnering with management, project champions, and business owners to communicate and align improvement initiatives with business objectives; identifying appropriate change management method and approach; and ensuring stakeholders embrace a change management mindset, understand intent and purpose, and foster a culture of change.

    • Performs data analyses to support business initiatives by identifying appropriate data analysis tools and approach to assess business performance; determining suitable data gathering and analysis methods (e.g., process observation, hard data, etc.); defining data requirements and obtaining customer agreements, including customer requirements as appropriate; conducting analyses and performing experimental tests to evaluate the effectiveness of business solutions; and identifying and alleviating risks through data-driven analysis.

    • Supports vendor management as required by assisting with reviews of vendor performance levels; ensuring service level agreements are met; managing vendor invoices; and partnering with Procurement and/or Legal to develop service level and/or scope of work agreements as appropriate.

    • Monitors compliance of work activities by ensuring business plans and team members adhere to KP, departmental, and/or business line policies and procedures.

  • 9 Days Ago

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IT Network Specialist
  • PG&E Corporation
  • San Ramon, CA FULL_TIME
  • Requisition ID # 154863 Job Category: Information Technology Job Level: Individual ContributorBusiness Unit: Information TechnologyWork Type: HybridJob Location: San Ramon Department OverviewInformati...
  • 28 Days Ago

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Human Resources Specialist
  • Donor Network West
  • San Ramon, CA FULL_TIME
  • Donor Network West’s mission is to save and heal lives through organ and tissue donation for transplantation and research. At Donor Network West, we're looking for people who embody our core values: p...
  • 16 Days Ago

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Stanford Audiologist - Walnut Creek/San Ramon
  • Stanford Health Care Provider Recruiting Team
  • Walnut Creek, CA FULL_TIME
  • Description Position at University Medical Partners Audiologist (Full-time)Stanford Medicine | University Medical PartnersWalnut Creek/San Ramon, CA University Medical Partners (UMP), a partner of Sta...
  • Just Posted

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Stanford Primary Care (IM or FM) - Part Time - East Bay
  • Stanford Health Care Provider Recruiting Team
  • Emeryville, CA PART_TIME
  • Description Position at University Medical Partners Family Medicine/Internal Medicine (Primary Care)University Medical PartnersEast Bay, CA (Alameda, Castro Valley, Emeryville, Hayward, San Pablo/Pino...
  • 3 Days Ago

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Stanford Primary Care (IM or FM) - Castro Valley
  • Stanford Health Care Provider Recruiting Team
  • Castro Valley, CA FULL_TIME
  • Description Position at University Medical Partners Family Medicine or Internal Medicine Physician (Primary Care) University Medical Partners | Stanford Medicine Castro Valley, CAUniversity Medical Pa...
  • 5 Days Ago

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0 Provider Network Specialist jobs found in Hayward, CA area

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Solutions Engineer - Network Engineer
  • Neetek Systems Integration Inc.
  • San Francisco, CA
  • Job Description Job Description Do you love designing or implementing corporate and data center networks? Have experienc...
  • 4/28/2024 12:00:00 AM

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Network Engineer
  • Collabera
  • Santa Clara, CA
  • DescriptionHomeSearch JobsJob DescriptionNetwork EngineerContract: Santa Clara, California, USSalary: $69.00 Per HourJob...
  • 4/28/2024 12:00:00 AM

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Network Engineer
  • Rw Joseph Consulting Group Inc.
  • Oakland, CA
  • Job Description Job Description About RW JOSEPH CONSULTING GROUP RW Joseph Consulting Group, Inc. (the Company) is a spe...
  • 4/28/2024 12:00:00 AM

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Network Engineer
  • Bayside Solutions
  • Concord, CA
  • Network Engineer W2 Contract Salary Range: $114,400 - $135,200 per year Location: Martinez, CA - Onsite Role Job Summary...
  • 4/27/2024 12:00:00 AM

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Network Engineer
  • Bayside Solutions
  • Concord, CA
  • Network Engineer W2 Contract Salary Range: $114,400 - $135,200 per year Location: Martinez, CA - Onsite Role Job Summary...
  • 4/26/2024 12:00:00 AM

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Network Engineer
  • Bayside Solutions
  • Martinez, CA
  • Network Engineer W2 Contract Salary Range: $114,400 - $135,200 per year Location: Martinez, CA - Onsite Role Job Summary...
  • 4/26/2024 12:00:00 AM

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Network Engineer
  • Info Way Solutions
  • Fremont, CA
  • Hi Professionals, This is Thiru from Info Way Solutions LLC, We have a job opening for a Network Engineer at Sunnyvale, ...
  • 4/25/2024 12:00:00 AM

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Network Engineer
  • Cordis
  • Santa Clara, CA
  • **Overview** **About Us:** Cordis is an independent, customer-focused global provider of interventional cardiovascular m...
  • 4/25/2024 12:00:00 AM

Hayward (/ˈheɪwərd/; formerly Haywards, Haywards Station, and Haywood) is a city located in Alameda County, California in the East Bay subregion of the San Francisco Bay Area. With a 2014 population of 149,392, Hayward is the sixth largest city in the Bay Area and the third largest in Alameda County. Hayward was ranked as the 37th most populous municipality in California. It is included in the San Francisco–Oakland–Fremont Metropolitan Statistical Area by the US Census. It is located primarily between Castro Valley and Union City, and lies at the eastern terminus of the San Mateo–Hayward Bridg...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Network Specialist jobs
$71,211 to $106,460
Hayward, California area prices
were up 4.5% from a year ago

Provider Network Specialist in Springfield, MO
As the liaison between provider and the health plan, candidates are tasked with ensuring improved revenue generated and patient quality score.
December 16, 2019
Provider Network Specialist in Stamford, CT
Previous experience in a network development, provider recruitment or provider contracting.
December 04, 2019
Provider Network Specialist in Fort Wayne, IN
In this position, employees will be expected to perform benefits analysis and create reports on provider performance to support the needs of the analysis found.
January 18, 2020