Provider Network Manager

The Provider Network Manager is responsible for managing and optimizing assigned segments of the provider network to ensure adequate access, strong provider performance, and alignment with organizational quality, financial, and growth objectives. This role serves as a key operational and relationship manager for physicians, IPAs, hospitals, and ancillary providers and acts as a primary point of contact for network-related issues within the assigned market. This position does not have direct reports but plays a critical role in influencing outcomes through collaboration with internal partners and external provider organizations., * Manage day-to-day performance and relationships for assigned providers, IPAs, hospitals, and specialty networks

• Monitor network adequacy, access standards, panel capacity, and geographic coverage to support membership growth and retention
• Identify network gaps, capacity constraints, and performance risks; recommend corrective actions to leadership

Provider Performance & Quality Support

• Support provider performance related to quality measures, utilization, and value-based care initiatives
• Collaborate with Quality, Medical Management, and Analytics teams to reinforce quality programs, incentive alignment, and performance improvement efforts
• Assist in driving improvement in key metrics such as HEDIS, STARS, utilization management, and member experience

Contract & Network Operations Support

• Partner with Contracting and Credentialing teams to support provider onboarding, terminations, network expansions, and contract implementation
• Ensure accurate provider data, network directories, and system configuration in collaboration with operations teams
• Support execution of provider incentive programs and contract-related initiatives

Provider Relations & Issue Resolution

• Serve as a primary escalation point for provider network issues, including access, operational challenges, and performance concerns
• Facilitate effective communication between providers and internal teams to resolve issues efficiently and maintain strong provider relationships
• Support preparation and participation in Joint Operating Committee (JOC) meetings and provider governance forums

Regulatory & Compliance Support

• Ensure network management activities comply with health plan requirements and state and federal regulations (e.g., DMHC, CMS)
• Support audits, regulatory submissions, and delegated risk requirements related to network operations
• Maintain documentation and reporting to support compliance and operational readiness

Cross-Functional Collaboration

• Partner closely with internal stakeholders including Medical Management, Quality, Claims, DSS/Analytics, Finance, Customer Service, and Government Programs
• Support implementation of network policies, workflows, and process improvements
• Provide market and provider insights to inform broader network strategy and leadership decision-making Performs other duties as assigned by the department leaders
• Other duties as assigned

Do you have experience in Utilization management?, Do you have a Bachelor's degree?, * Bachelor's degree in Healthcare Administration, Business, Public Health, or a related field

• At least 5 years of experience in provider network management, provider relations, or managed care operations
• Have experience working with physician networks, IPAs, hospitals, or health plans
• Strong understanding of managed care, delegated risk models, and provider network operations

You're great for the role if:

• Have experience working with delegated risk or value-based care models
• Experience in California managed care markets
• Familiarity with DMHC access standards, CMS requirements, and delegated risk oversight
• Advanced degree (MBA, MHA, MPH) a plus

9700 Flair Drive, El Monte, CA 91731 Hybrid work $75,000 - $88,000 a year - Full-time, * The total compensation target pay range for this role is: $75,000 - $88,000. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.

Astrana Health (NASDAQ: ASTH) is a physician-centric, technology-powered healthcare management company. We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner. Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise to improve patient outcomes, increase access to healthcare, and make the US healthcare system more efficient. Our platform currently empowers over 20,000 physicians to provide care for over 1.7 million patients nationwide. Our rapid growth and unique position at the intersection of all major healthcare stakeholders (payer, provider, and patient) gives us an unparalleled opportunity to combine clinical and technological expertise to improve patient outcomes, increase access to quality healthcare, and reduce the waste in the US healthcare system.