Los Angeles Health Services Partnership and Network Management Specialist III

Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.)

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.

Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.

Job Summary

3 Positions Available.

The Los Angeles Health Services Partnership (LAHS) and Network Management Specialist III serves as a strategic partner within the provider ecosystem, leading complex contracting efforts and ensuring alignment with organizational strategies and regulatory standards. Acting as the primary liaison for provider relations, the Specialist drives proactive engagement, oversees onboarding and education, and maintains transparent communication across the network. This role manages the full lifecycle of provider issues, applying analytical frameworks to resolve concerns and develops scalable solutions that enhance provider and member experience.

The Specialist operationalizes value-based care initiatives, monitors contractual benchmarks, and synthesizes data into actionable insights for leadership. Cross-functional collaboration is central, uniting internal teams to achieve provider performance goals. Reinforces structured processes, and models data-driven decision making, fostering a culture of accountability and service excellence. Acts as a Subject Matter Expert (SME), serves as a resource and mentor for other staff.

Duties

Serves as a strategic integrator across the entire provider ecosystem, contracting, relationship management, engagement, and performance oversight. Leads high‑value contracting efforts, negotiates and executes complex agreements across professional, facility, vendor, and ancillary providers while ensuring that contractual terms align with organizational strategy and regulatory expectations.

Functions as the primary liaison between the organization and its diverse provider network, driving structured, proactive engagement that strengthens relationships and promotes operational excellence. This includes overseeing orientation, onboarding, education, and continuous communication, ensuring transparency and consistency across all provider interactions.

Responsible for the full lifecycle of provider concerns, applying a disciplined approach from intake to root‑cause analysis through solution development and validation. Leverages analytical frameworks to assess financial, regulatory, member, and operational impacts. Applies this expertise to enable the timely resolution of escalated issues, the prevention of recurring challenges, and the development of scalable solutions that enhance both provider and member experience.

Responsible for operationalizing value‑based care initiatives and monitoring progress against contractual benchmarks, synthesizing data into actionable insights for leadership review. Through structured project practices, drives implementations to successful, on‑schedule completion and prepares analytic reports that inform enterprise decision‑making.

Cross‑functional collaboration is a hallmark of the position. Acts as a central coordinator unites internal teams to align efforts, share insights, and ensure collective execution against provider performance goals.

Reinforces structured processes and documentation standards, and modeling disciplined, data‑driven decision‑making. Provides guidance to help shape a culture of accountability, responsiveness, and service excellence within the provider engagement and contracting functions.

Drives measurable improvements in provider performance, advancing network optimization, and supporting the organization’s mission through effective relationship and contract management.

Apply subject matter expertise in evaluating business operations and processes. Identify areas where technical solutions would improve business performance. Consult across business operations, provide mentorship, and contribute specialized knowledge. Ensure that the facts and details are correct so that the program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices. Provide training and recommend process improvements as needed.

Performs other duties as assigned.

Duties Continued

Education Required

Bachelor's Degree in Business Administration or Related Field

In lieu of degree, equivalent education and/or experience may be considered.

Education Preferred

Experience

Required

• At least 4 years of progressive experience in managed care contracting, provider relations, health plan operations, or hospital/facility settings.
• Demonstrated success negotiating, executing, and ensuring regulatory compliance for complex agreements.
• At least 3 years in provider-facing progressively responsible professional roles with executive-level relationship management.
• Proven track record coordinating cross-functional initiatives and using data to improve outcomes.

Preferred

Extensive experience with Medi-Cal, Medicare Advantage, DHCS, DMHC, CMS, and NCQA.

Skills

Required

• Advanced expertise in negotiating and managing high-value, complex agreements.
• Deep knowledge of managed care operations and delegated risk environments.
• Strong expertise in root-cause analysis, operational improvement, and data-driven decision-making, ensuring strong SLA governance.
• Effective stakeholder management skills which bridges cross functional groups, while high level presence enables provider advocacy, conflict resolution, and strategic team development.
• Excellent organizational skills, adept at managing multiple projects, documenting decisions, and following through on action items.
• Proficiency with office productivity tools supports robust analysis, clear presentations, and timely stakeholder updates.

Preferred

• Adept in capitation, value-based care, provider contracting, and hospital partnerships.
• Advanced knowledge of provider data management, directory standards, and regulatory reporting supports effective oversight.
• Ability to lead provider trainings, crafts targeted communications, and resolve complex operational and payment issues.
• Familiarity with medical coding frameworks (ICD-10, CPT) and cross-functional collaboration skills which enables strong representation of contracting and provider relations in organizational initiatives.

Licenses/Certifications Required

Licenses/Certifications Preferred

Required Training

Physical Requirements

Light

Required

• Travel to offsite locations for work required.
• Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.
• L.A. Care offers a wide range of benefits including

Paid Time Off (PTO)

Tuition Reimbursement

Retirement Plans

Medical, Dental and Vision

Wellness Program

Volunteer Time Off (VTO)