Provider Network Specialist II

At Call the Car, we believe everyone deserves access to the healthcare they need without barriers. Our company was founded after identifying a critical gap in care that prevented many individuals from attending important medical appointments. By recognizing the need for reliable transportation and addressing key Social Determinants of Health (SDoH), we set out to create solutions to help people reach the care they deserve. Our mission is to redefine Non-Emergency Medical Transportation (NEMT) as not just a ride, but as a pathway to healthier lives, stronger communities, and greater healthcare equity.Guided by our core values of Compassion, Empower, Flexible, and Caring, we are committed to delivering service that is not only reliable, but also respectful, supportive, and centered on the unique needs of every member we serve. We are looking for passionate individuals to join us in making a meaningful impact. Together, we can help address barriers to healthcare, provide peace of mind through every ride, and create connections that move our communities toward better health, greater independence, and brighter futures. Basic Job Purpose: Under the supervision of the Vendor Network Manager, the Provider Network Specialist II researches and recruits new subcontractors, supports the initial subcontractor contracting process, and helps ensure subcontractor compliance with contractual obligations.

RESPONSIBILITES/DUTIES:

Build :Supports provider recruitment, contracting, network adequacy analysis, gap identification, and onboarding. Train :Educates providers on CTC processes, contractual obligations, technology/API requirements, billing expectations, and client-specific requirements. Monitor :Tracks on-time performance, missed trips, complaints, FOCs, API/GPS compliance, credentialing issues, utilization, and other key performance indicators. Manage :Conducts regular provider check-ins, review scorecards, provide coaching, and implement corrective actions. Enforce :Ensures compliance with contract requirements, manage remediation plans and escalations, and recommend suspension or termination when necessary. Grow :Identifies opportunities to expand network capacity, improve levels of service coverage, and strengthen provider partnerships. Leads targeted research to identify potential subcontractors in emerging and existing service areas, in alignment with dispatch needs and new client contract requirements. Optimizes subcontractor onboarding, including contracting and credentialing processes, to support efficiency and compliance. Assists the Vendor Network Manager with monthly reporting on pending Medi-Cal enrollments, credentialing audits, provider metrics, and API performance, including follow-up, strategic updates, and subcontractor issue resolution. Assists the Vendor Network Manager in establishing and enforcing standardized provider document verification processes to support contract compliance and accurate credentialing records. Maintains strong, collaborative relationships with the Contracting and Credentialing Teams, Call the Car employees, transportation providers, and other key stakeholders. Collaborates with the Vendor Network Manager to develop and implement communication strategies that set clear expectations and support timely completion of provider requirements. Partners with Dispatch to address network inadequacies, leads outreach to expand provider capacity, ensures service continuity, and collaborates with other departments on contracting-related items. Assists the Vendor Network Manager with managing and coordinating bus pass distribution for specific clients, ensuring accuracy and efficiency. Identifies process improvement opportunities and present strategic recommendations to leadership. Facilitates clear communication between Providers, Drivers, and CTC leadership to promote transparency and collaboration. Ensures 100% accuracy and compliance across all aspects of the contracting and credentialing process. Mentors and guides Specialists to support professional development and consistent performance. Assumes responsibility for special projects and initiatives assigned by management. Able to assist with complex high-level contracting or credentialing matters Performs all other duties assigned by management.

PERFORMANCE REQUIREMENTS:

Knowledge, skills and abilities: At least 2-3 years of relevant Credentialing or Contracting experience; experience in healthcare, transportation, or quality improvement setting preferred. Bachelor's or associate degree preferred; High School Diploma or GED required. Proficiency with Microsoft Office (particularly Excel, Outlook, and Word) required. Possesses organizational skills with close attention to detail. Strong verbal and written communication skills with the ability to interact collaboratively with team members and professionally with external contacts. Ability to adapt quickly to changing priorities and handle multiple tasks simultaneously. Strong problem-solving and critical thinking skills, along with the ability to multitask and manage time well in a fast-paced, team-oriented environment. Basic knowledge or willingness to learn CTC systems and procedures, including but not limited to CTC Connect, dispatch software, customer service protocols, and client expectations. Advanced analytical skills -- ability to make recommendations by using data to identify trends. Comfortable working independently with guidance from management. Ability to type at least 40 wpm. Must pass a Criminal Background Screening. Must pass government exclusion list at time of hire and monthly thereafter.

TYPICAL WORKING CONDITIONS:

The typical working condition for this position is on-site in an indoor office environment with controlled climate, lighting, and noise levels. The job may require extended periods of sitting, standing, kneeling, bending, and/or lifting of at least 25 lbs. This is an on-site position. Employees are expected to work from the office during scheduled business hours. Remote work is not available for this role. The use of a computer or other office equipment is also a requirement. Some evening, weekend, and/or holiday work and light travel may be necessary. #J-18808-Ljbffr Call The Car, Inc.