AHN/AHNSS Operations Specialist

Operations Specialist

If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn't just welcomed – it's nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don't just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it's a calling that drives us forward every day.

Job Overview

The AHN/AHNSSP Operations Specialist supports the AHN Operations and Delegated Oversight team in the execution and monitoring of delegated managed care functions, including but not limited to Claims Operations, Provider Network Management, and Credentialing. This role is responsible for monitoring audit readiness activities, tracking regulatory compliance, facilitating cross-functional submissions, and ensuring delegated operational performance aligns with contractual and regulatory standards. This position serves as a key operational liaison between internal functional teams and health plan partners, ensuring timely and accurate responses to oversight requests, audits, reporting obligations, and corrective action initiatives. The role is execution-driven, compliance-focused, and highly collaborative, with responsibility for day-to-day delegation monitoring activities.

Minimum 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 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.

Compensation

$35.91 - $44.88 hourly

Compensation Disclaimer

Actual salary offers are considered by various factors, including budget, experience, skills, education, licensure and certifications, and other business considerations. The range is subject to change. AltaMed is committed to ensuring a fair and competitive compensation package that reflects the candidate's value and the role's strategic importance within the organization. This role may also qualify for discretionary bonuses or incentives.

Benefits & Career Development

• 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

AltaMed Health Services Corp. will consider qualified applicants with criminal history pursuant to the California Fair Chance Act and City of Los Angeles Fair Chance Ordinance for Employers. You do not need to disclose your criminal history or participate in a background check until a conditional job offer is made to you. After making a conditional offer and running a background check, if AltaMed Health Service Corp. is concerned about a conviction directly related to the job, you will be given a chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.