Operations Specialist
AltaMed Health Services
full-time
Posted on:
Location Type: Hybrid
Location: Montebello • California • United States
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Salary
💰 $36 - $45 per hour
About the role
- Supports the AHN Operations and Delegated Oversight team in execution and monitoring of delegated managed care functions.
- Responsible for monitoring audit readiness activities, tracking regulatory compliance, facilitating cross-functional submissions, and ensuring delegated operational performance aligns with contractual and regulatory standards.
- Acts as a key operational liaison between internal functional teams and health plan partners.
- Ensures timely and accurate responses to oversight requests, audits, reporting obligations, and corrective action initiatives.
- Responsible for day-to-day delegation monitoring activities.
Requirements
- High school diploma or equivalent required; Associate’s or Bachelor’s degree preferred.
- Minimum of 3 years of experience in managed care operations (including but not limited to Claims, Provider Network Management and/or Credentialing) required.
- Minimum 1 year of experience supporting delegation oversight, audit coordination, or regulatory compliance functions required.
- Strong working knowledge of CMS, California state regulations, Medicare, Medi-Cal, and Commercial managed care requirements required.
- Minimum 1 year of experience preparing audit documentation and corrective action plans required.
Benefits
- Medical, Dental and Vision insurance
- 403(b) Retirement savings plans with employer matching contributions
- Flexible Spending Accounts
- Commuter Flexible Spending
- Career Advancement & Development opportunities
- Paid Time Off & Holidays
- Paid CME Days
- Malpractice insurance and tail coverage
- Tuition Reimbursement Program
- Corporate Employee Discounts
- Employee Referral Bonus Program
- Pet Care Insurance
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
managed care operationsaudit coordinationregulatory compliancedelegation oversightclaims managementprovider network managementcredentialingaudit documentation preparationcorrective action plans
Soft Skills
communicationorganizationalcross-functional collaborationliaison