Provider Network Manager (San Fernando)
Astrana Health, Inc., El Monte, CA, United States
Provider Network Manager (San Fernando)
Department:
Market Ops - APC
Employment Type:
Full Time
Location:
9700 Flair Drive, El Monte, CA 91731
Reporting To:
James Agronick
Compensation:
$78,567 - $100,828 / year
Description
Job Title: Provider Network Manager
Department: Network Management
About the Role: The Provider Network Manager is responsible for managing and optimizing assigned segments of the provider network in San Fernando Valley 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.
What You'll Do
Provider Network Management & Optimization
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
Qualifications
5+ years of experience in provider network management, provider relations, or managed care operations
Experience working with physician networks, IPAs, hospitals, or health plans
Strong understanding of managed care, delegated risk models, and provider network operations Preferred • 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
You're great for the role if:
Bachelor's degree in Healthcare Administration, Business, Public Health, or a related field. Advanced degree (MBA, MHA, MPH) a plus
Environmental Job Requirements and Working Conditions
Our organization follows a hybrid work structure where the expectation is to work both in office and at home on a weekly basis. The office is located at 9700 Flair Drive, El Monte, CA 91731.
The total compensation target pay range for this role is: $78,566.91 - $100,827.53. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action Employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
Department:
Market Ops - APC
Employment Type:
Full Time
Location:
9700 Flair Drive, El Monte, CA 91731
Reporting To:
James Agronick
Compensation:
$78,567 - $100,828 / year
Description
Job Title: Provider Network Manager
Department: Network Management
About the Role: The Provider Network Manager is responsible for managing and optimizing assigned segments of the provider network in San Fernando Valley 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.
What You'll Do
Provider Network Management & Optimization
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
Qualifications
5+ years of experience in provider network management, provider relations, or managed care operations
Experience working with physician networks, IPAs, hospitals, or health plans
Strong understanding of managed care, delegated risk models, and provider network operations Preferred • 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
You're great for the role if:
Bachelor's degree in Healthcare Administration, Business, Public Health, or a related field. Advanced degree (MBA, MHA, MPH) a plus
Environmental Job Requirements and Working Conditions
Our organization follows a hybrid work structure where the expectation is to work both in office and at home on a weekly basis. The office is located at 9700 Flair Drive, El Monte, CA 91731.
The total compensation target pay range for this role is: $78,566.91 - $100,827.53. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action Employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.