Network Operations Specialist II

L.A. Care Health Plan•Los Angeles, CA

1d•$77,265 - $123,625•Onsite

About The Position

The Network Operations Specialist II supports managed care and payment initiatives by translating program requirements into actionable tasks and coordinating cross-functional teams. This role maintains operational logs, tracks deliverables, and provides routine updates to leadership. Responsibilities include summarizing regulatory directives, drafting business requirements, monitoring process adherence, and documenting corrective actions. The specialist builds and updates key performance indicators (KPIs) and dashboards, ensures audit readiness, and collaborates with key stakeholders to facilitate operational changes and system enhancements. The Network Operations Specialist II plays a role in advancing managed care and payment initiatives by translating complex program requirements into actionable work packages and task lists. This role is central to the coordination of cross-functional workgroups, ensuring seamless collaboration by meticulously tracking deliverables, documenting key decisions, and proactively reporting blockers to leadership.

Requirements

At least 3 years of experience in managed care, network operations, or a related field.
Experience supporting program execution, regulatory review, and documentation within healthcare or network operations environments.
Experience collaborating across teams and maintain accurate records and consistently contribute to operational excellence and compliance, ensuring that organizational objectives are met through effective teamwork and meticulous attention to detail.
Ability to excel at translating program requirements into clear tasks and timelines, ensuring projects are executed efficiently and on schedule.
Foundational knowledge and understanding of regulatory directives and operational processes.
Adept at tracking deliverables, maintaining comprehensive logs, and preparing routine updates for stakeholders.
Strong organizational and communication (written and verbal) skills.
Effective collaboration and precise documentation Skills.
Knowledge and understanding of KPI tracking, dashboard management, and audit documentation, supporting operational transparency and continuous improvement.
Detail oriented with ability to thrive in a dynamic environment.

Nice To Haves

Experience in data analysis and process improvement, consistently identifying opportunities to enhance operational efficiency.
Knowledge of payment methodologies including hospital-directed payments and alternative payment models with the ability to contribute to informed decision-making in complex healthcare environments.
Exposure and skills in provider communications, portal adoption, and manual updates that enable effective stakeholder engagement and operational transparency.
Ability to collaborate with key stakeholders that support system enhancements and reporting initiatives, ensuring that technical solutions align with organizational goals.

Responsibilities

Maintains operational excellence through diligent upkeep of implementation logs and the provision of routine updates, empowering leadership with timely insights.
Supports regulatory compliance by intaking and summarizing directives such as Apls, drafting foundational business requirements, and aligning tasks across impacted teams.
Monitors process adherence and documenting corrective actions, reinforcing a culture of continuous improvement.
Builds and updates KPIs and operational dashboards, assists in trend analysis, and prepares briefing materials that inform strategic decision-making.
Ensures audit readiness by keeping policies, procedures, and workflow documentation current, and by systematically filing and versioning artifacts.
Coordinates manual updates and distribution controls, schedules meetings, publishes agendas and notes, and follows up on action items with stakeholders.
Supports the deployment of provider notices and web updates related to operational changes, and partners with IT/Data teams to facilitate system changes, reporting specifications, and user acceptance testing.
Supports operational integrity and strategic objectives across the enterprise.
Performs other duties as assigned.