Provider Engagement Specialist – San Diego County (Field Remote) (Finance)

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

Location: San Diego, CA (Field-based, must reside in San Diego County)
Job Type: Full-time | Regular Employee
Work Arrangement: Remote (Field-based, 80%+ local travel required)
About the Role
We are seeking a Provider Engagement Specialist to join our team and support the performance, operations, and growth of our provider network within the San Diego market. This role is ideal for someone who thrives in a field-facing position, enjoys building relationships, and is passionate about improving access and outcomes in managed care.
You will serve as the primary liaison between the organization and our network of primary care and specialty providers-conducting outreach, supporting provider education, assisting in contracting efforts, and helping to resolve provider-related issues. Your efforts will directly support network performance, HEDIS benchmarks, and Risk Adjustment initiatives.

Key Responsibilities

• Build and maintain collaborative relationships with providers, office staff, and ancillary partners.
• Conduct initial and ongoing provider orientations, trainings (including Model of Care), and issue resolution support.
• Perform field visits to address provider concerns related to claims, authorizations, eligibility, and directory updates.
• Support contracting and credentialing activities, including collecting necessary documentation and initiating standard provider agreements.
• Track provider outreach and contracting status using Salesforce and other internal systems.
• Assist in the development of educational and implementation materials.
• Maintain weekly activity summaries and support internal reporting efforts.
• Coordinate targeted outreach campaigns using customized email distribution lists.
• Support departmental special projects aimed at provider engagement and performance improvement.

Minimum Requirements:

• High school diploma or GED required.
• Valid driver's license, auto insurance, and reliable transportation required.
• Must reside in San Diego County and be available for frequent field travel (80% or more).
• One year of provider relations, contracting, or healthcare network operations experience in an HMO, IPA, or medical group setting.
• Proficiency in MS Office (Excel, Word, PowerPoint).
• Strong communication, relationship-building, and problem-solving skills.
• Comfortable working independently in a field-based, fast-paced environment.

Preferred:

• Bachelor's degree (or 4 years additional relevant experience in lieu).
• 2+ years of experience in provider engagement, managed care, or health plan operations.
• Understanding of HEDIS, Risk Adjustment, and Managed Care operations.
• Bilingual in English and another language (e.g., Spanish, Tagalog) a plus.

Work Environment & Travel

• This is a field-remote role, with significant travel within the San Diego area to meet with providers.
• Occasional air travel may be required.
• Work may occasionally require extended hours based on operational needs.
• Reasonable accommodations will be made for individuals with disabilities.

Why Join Us?

This is a great opportunity to represent a mission-driven healthcare organization committed to quality, access, and innovation. You'll have the chance to make a meaningful impact in the San Diego community while growing your career in provider relations and managed care.

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.

2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
Pay Range: $58,531.00 - $87,797.00
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/ . If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health's talent acquisition team, please email careers@ahcusa.com .