Provider Services Advocate
About The Position
The Provider Services Advocate serves as a primary liaison between a California-based Independent Practice Association (IPA) and its contracted provider network (primary care, specialists, ancillary providers, and clinic staff). This role supports provider satisfaction and operational performance by resolving provider inquiries, educating offices on IPA processes (authorizations, referrals, claims/payment, eligibility, and delegated functions), and facilitating issue resolution across internal departments and external partners. The Advocate conducts routine and as-needed clinic visits – including travel to the Low Desert area – to strengthen relationships, reinforce standards, and identify improvement opportunities that enhance access, quality, and service.
Requirements
- High School diploma or equivalent required.
- 2+ years of experience in managed care, healthcare administration, MSO, IPA, medical group, health plan, or provider office environment.
- Knowledge of managed care operations, providers networks, and healthcare delivery systems.
- Knowledge of claims processing, eligibility, and credentialing processes.
- Knowledge of Medicare, Medi-Cal, Commercial, PPO, and HMO plan structures.
- Strong customer service and provider support skills.
- Excellent verbal and written communication skills.
- Strong problem-solving and analytical skills.
- Ability to manage multiple tasks and prioritize workload.
- Strong attention to detail and organizational skills.
- Proficiency in Microsoft Office Suite (Word, Excel, Outlook).
- Ability to maintain confidentiality and handle sensitive information.
- Ability to work independently and collaboratively in a team environment.
- Any combination of educational and work experience that would be equivalent to the stated minimum requirements would qualify for consideration of this position.
Nice To Haves
- Bachelor’s degree in healthcare administration, public health, or related field.
- Experience supporting provider relations, claims, credentialing, or health plan operations.
- Experience working in California managed care environment.
- Experience working with MSO, IPA, or delegated managed care operations.
Responsibilities
- Serve as a primary liaison between the IPA and its contracted provider network.
- Support provider satisfaction and operational performance.
- Resolve provider inquiries.
- Educate provider offices on IPA processes (authorizations, referrals, claims/payment, eligibility, and delegated functions).
- Facilitate issue resolution across internal departments and external partners.
- Conduct routine and as-needed clinic visits, including travel to the Low Desert area.
- Strengthen provider relationships.
- Reinforce IPA standards.
- Identify improvement opportunities that enhance access, quality, and service.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
