Network Operations

• Facilitate compliance-related activities to meet health plan, DMHC, DHCS, and regulatory requirements
• Support provider network operations including onboarding, terminations, issue resolutions, communications, credentialing, provider updates, and department file maintenance
• Coordinate provider-related operational activities across Contracting, Credentialing, Claims, and Network Management
• Assist Network Management provider engagement functions
• Intake, research, track, and resolve provider inquiries and operational issues
• Escalate complex or systemic issues to leadership
• Maintain accurate provider records, interaction documentation, and workflows
• Assist with audits, directory validation, and regulatory reporting
• Support provider network operations and performance reports
• Partner with Provider Network, Credentialing, Contracting, Claims, and Quality teams
• Participate in network optimization and operational improvement initiatives
• Support market-specific network initiatives
• Coordinate with Quality and Risk to distribute reports and collect provider data
• Ensure compliance with health plan requirements, company policies, and state and federal regulations
• Follow workflows and contribute to process improvements
• Support internal and external audit readiness
• Perform other duties as assigned

Explore Provider Network Operations Representative at Astrana Health. Review requirements and application details.