Transportation Network Representative

Inland Empire Health Plan•Rancho Cucamonga, CA

10d•$27 - $36•Hybrid

About The Position

The Transportation Network Representative is the frontline field role and primary point of contact for transportation providers and facilities. The position supports provider coaching, training, onboarding, and enforcement of performance standards to ensure service quality and compliance. It executes audits and inspections, coordinates facility liaison activities, and manages scheduling and trip-level triage to maintain timely and accurate transportation services. The role also conducts member and provider outreach, prepares accounts payable evidence packages, maintains detailed documentation, and supports Voice of Member initiatives to enhance member experience. Success requires strong organization, attention to detail, and effective relationship-building with providers and facilities. The position is committed to incorporating IEHP Quality Program goals, including HEDIS, CAHPS, and NCQA Accreditation. It follows a hybrid schedule: remote on Mondays and Fridays and onsite Tuesday through Thursday in Rancho Cucamonga, California. The role is primarily office-based, with frequent virtual meetings and collaboration with internal departments and external vendors. Occasional travel within the service region and to vendor sites is required, potentially outside normal business hours for urgent operational needs or regulatory audits. Extended hours may be required during peak periods, audits, or escalated issues.

Requirements

At least three years of experience in a combination of transportation operations, provider relations, and/or healthcare network coordination.
Experience training and onboarding providers on operational processes and compliance standards.
Field-based work experience and clear policy communication skills.
High School Diploma or GED.
Valid California driver's license and valid automobile insurance; must qualify for and maintain a driving record that meets IEHP insurance standards, with no more than three points.
Knowledge of NEMTAC standards and competency guidelines.
Knowledge of healthcare compliance standards, including CMS, DHCS, DMHC, and Medi-Cal transportation benefit regulations.
Knowledge of provider performance management frameworks, including scorecards and action improvement plans.
Knowledge of dispatch optimization principles and trip assignment best practices.
Knowledge of standard operating procedures for Standing Orders, PCS forms, and credentialing enforcement.
Basic knowledge of billing integrity and fraud detection protocols.
Understanding of transportation workflows and the impact of missed or delayed trips on member experience.
Intermediate proficiency with Microsoft Excel, including pivot tables and VLOOKUP, and Microsoft Word for policy documentation.
Ability to run and interpret trip-level and provider performance reports.
Familiarity with scheduling and dispatch platforms for trip assignment optimization.
Competence using data analysis tools for KPI tracking and Voice of Member analytics.
Basic knowledge of Accounts Payable processes and assembling billing evidence packages.
Familiarity with provider portals and/or dispatching software.
Strong analytical, documentation, communication, relationship-building, problem-solving, adaptability, organizational, and attention-to-detail skills.
Ability to collaborate with cross-functional teams, including Accounts Payable, Finance, and Operations.

Nice To Haves

Experience supporting managed care claims, encounters, and billing dispute resolution.
Background in high-volume, operationally complex environments with multiple vendor relationships.
Contribution to Voice of Member or Customer Experience initiatives, including accurate tagging, issue categorization, and supporting closed-loop improvements.
Associate’s degree in Healthcare Administration, Business Administration, or a related field from an accredited institution.
Passenger Assistance, Safety and Sensitivity (PASS) Certification from the Community Transportation Association of America (CTAA).
Familiarity with IEHP transportation policy, Medi-Cal regulations, and NEMT authorization processes.

Responsibilities

Serve as the primary contact for assigned transportation providers and facilities, conducting at least 10 proactive, meaningful engagements per provider or facility annually.
Respond to and resolve issues within established Service Level Agreements, document interactions fully, and escalate safety, compliance, or contractual concerns to the Supervisor.
Maintain documentation for audits, Fraud, Waste, and Abuse investigations, and Accounts Payable processes.
Coach, train, and onboard providers; communicate compliance requirements and service expectations; and use structured engagements and improvement actions to enforce performance standards.
Perform unannounced live trip audits and virtual or in-person vehicle inspections; validate GPS and timestamp accuracy and provide coaching regarding observed safety or compliance issues.
Serve as the single point of contact for assigned facilities; assist with Standing Order configuration and PCS form distribution; train facility staff on booking and authorization processes; and promote portal adoption and compliance.
Triage and resolve day-of trip exceptions, including late, missed, or disrupted trips, and ensure on-time pickup and drop-off.
Escalate safety or time-sensitive concerns according to standard operating procedures.
Conduct member and clinical provider outreach, including 60-, 30-, and 15-day reminders, to obtain or refresh PCS forms and Standing Orders; accurately capture and file documentation.
Assemble manifests, GPS logs, authorization records, and communications to resolve invoice discrepancies for Uber/Lyft and transportation providers, supporting billing integrity and reducing Accounts Payable rework.
Perform other duties as required to support Health Plan operations and department business needs.