Network Management Implementation Specialist

SCAN Health Insurance•Long Beach, CA

1d•Remote

About The Position

The Network Management Implementation Specialist plays a critical role in managing and coordinating the end-to-end onboarding and offboarding processes for contracted medical groups and providers within SCAN’s network. This role combines operational implementation, process improvement, and systems integration support to ensure a seamless provider experience at initial contracting and during offboarding and member transitions. The Implementation Specialist captures and defines business requirements, develops and maintains process documentation, and ensures system data integrity as part of SCAN’s ongoing system modernization efforts. The position partners closely with key departments – including, Contracting, Delegation Oversight, Credentialing, Provider Relations, Network Training, Communications, Provider Data Management, Configuration, Finance, Claims, Clinical Operations, Member Services, IT, etc. to ensure compliance, accuracy, and timeliness across all operational and technical implementation for provider onboarding and offboarding. This includes ongoing improvements to provider onboarding materials, educational experiences, and outreach efforts, as well as the adoption of new tools, templates, and processes designed to enhance team efficiency and the overall provider experience for onboarding and offboarding. This role is responsible for supporting continuous quality improvement, validating and coordinating system enhancements, monitoring critical business processes, and maintaining a consistent feedback loop to refine workflows and ensure operational readiness for provider onboarding and offboarding. By bridging technical, procedural, and relational aspects of provider management, the Implementation Specialist ensures operational excellence and alignment with SCAN’s strategic goals for provider onboarding and offboarding.

Requirements

3-5 years' experience in provider network management, healthcare operations, or implementation roles requiring cross-functional collaboration, process coordination, and strong communication skills.
At least 3 years’ experience in provider onboarding and direct provider engagement, including delivering presentations and facilitating discussions on operational workflows, onboarding expectations, and compliance requirements.
Must demonstrate a solid understanding of Medicare Advantage operations and provider-facing processes.
Bachelor's Degree or equivalent experience required.
Skilled in Microsoft Office (Word, Excel, Outlook, Teams, PowerPoint, Visio).

Nice To Haves

Graduate or Advanced Degree or equivalent experience preferred.

Responsibilities

Coordinate end-to-end provider onboarding and offboarding management: Project manage all cross-functional tasks and deliverables associated with the provider onboarding, including pre-delegation audits, roster loading and display, MFT setup, claims payment configuration, and reporting activation to ensure seamless onboarding experiences.
Manage provider offboarding processes: Ensure smooth offboarding when a provider terminates or changes MSO affiliation by coordinating member reassignment, provider data removal, report deactivation, and compliant member communication in partnership with internal teams.
Develop and maintain workflows and documentation: Design, implement, and regularly update standardized workflows, procedures, and timelines to support consistent practices, operational readiness, and data integrity throughout the full provider lifecycle. Ensure clear operational handoffs across departments and adherence to established timelines for onboarding and offboarding activities.
Collaborate with Network Training and Compliance teams: Partner with the Network Training Specialist for all education and training needs, and work with the Compliance team to confirm all policies, desktop procedures, and materials associated to provider onboarding and offboarding comply with regulatory and organizational standards.
Monitor project milestones and risk management: Track and analyze project deliverables, identify risks or process gaps, and coordinate timely resolutions with business partners to maintain accuracy and efficiency across operational readiness for provider onboarding and offboarding.
Serve as subject matter expert and liaison: Represent Network Management in cross-functional meetings and governance committees related to provider onboarding and offboarding, providing insight and expertise on provider implementation, configuration readiness, and operational optimization.
Ensure regulatory and audit readiness: Promote compliance and adherence to CMS, DMHC, DHCS, and NCQA requirements through accurate documentation, lifecycle tracking, and post-termination data closure activities to maintain audit preparedness and meet quality standards.
Facilitate provider communications, education, and presentations: Collaborate with Network Training and Communications teams to enhance provider onboarding materials, orientation tools, and outreach initiatives enhancing provider understanding and engagement. Conduct provider presentations and engage directly with provider partners to ensure clarity around onboarding expectations, operational workflows, and ongoing requirements.
Drive continuous process improvement: Identify and implement enhancements to workflows, tools, templates, and reporting processes that increase efficiency, accuracy, and provider satisfaction throughout the lifecycle.
Support system modernization and integration efforts: Contribute to SCAN’s system improvement and migration projects by capturing business requirements, testing enhancements, validating changes, and supporting implementation during and after release.
Actively support the achievement of SCAN’s Vision and Goals.
Other duties as assigned.

Benefits

Base salary range: $71,700 to $103,732 per year.
An annual employee bonus program
Robust Wellness Program
Generous paid-time-off (PTO)
Eleven paid holidays per year, plus 1 floating holiday, plus 1 birthday holiday
Excellent 401(k) Retirement Saving Plan with employer match and contribution
Robust employee recognition program
Tuition reimbursement
An opportunity to become part of a team that makes a difference to our members and our community every day!
A competitive compensation and benefits program
An annual employee bonus program
Generous paid-time-off (PTO)
Eleven paid holidays per year
Excellent Retirement Savings program
A work-life balance
An opportunity to become part of a team that makes a difference to our members and our community every day!