Alignment Health · 19 hours ago
Director, Network Management (San Diego County)
San Diego, CA
Full-time
Onsite
Director/Executive
$113K/yr - $170K/yr
10+ years expAlignment Health is committed to serving seniors and those who need it most, focusing on transforming their lives through dedicated care. The Director, Network Management is responsible for addressing network management needs, leading clinical performance activities, and providing technical leadership for both regional and corporate initiatives.
Health CareHospitalMedicalMedical DeviceWellness
Responsibilities
Lead and facilitate join operations committee meetings (JOC) with MSO, IPA and Direct Ancillary contracted providers
Lead and manage provider service representatives to maximize engagement through consistent face-to-face interactions, in-service visits, training sessions and JOC participation to improve performance and growth initiatives
Review, analyze and develop strategies based on historical performance data and trend performance metrics promoting growth, CAHPS, RAF, STARS, Benefit Orientation, AVA (Alignment Virtual Application). Types of providers: PCP, Specialist, SNFs, ASCs, Home-Health, DMEs (all ancillary providers)
Train and manage direct reports to capture and document provider interactions in the designated database to ensure proper tracking of action items and performance metrics are being followed
Oversight of provider service representative’s strategy and schedules to ensure department goals and requirements are being met
Weekly status update to VP - Track and report network performance and opportunities for assigned regions
Analyzes current and projected network needs from cost/utilization and competitor standpoints
Collaborate with regional executive team and other departments to ensure contracted network support of operating goals, including STARS, HEDIS, RAF, and other initiatives
Contributes expertise to development of organizational best practices
Oversees assigned staff. Responsibilities include recruiting, selecting, orienting, and training employees; assigning workload; planning, monitoring, and appraising job results; and coaching, counseling, and disciplining employees. Will also oversee third-party vendors and/or student workers as appropriate
Qualification
Required
10 years of experience in managed care or health care field, including a strong understanding of reimbursement methodologies, contract language, negotiation strategies, financial modeling and analysis, managed care and Medicare Advantage plans; or any combination of education and experience, which would provide an equivalent background
Experience with delegated and non-delegated providers
Requires a BA/BS; MBA preferred
Must have strong analytical skills and customer service skills
Excellent knowledge of hospitals and managed care finance and contracts
Strong knowledge of Medicare managed care and associated contract language
Excellent interpersonal and relationship management skills
Excellent oral, written and presentation skills
Proven ability to foster collaboration, value others perspective and gain support and buy-in for organization proposal
Excellent Microsoft Office skills, including Word and Excel
Ability to travel by car or air
Available for evenings/weekends and extended work hours as needed
Preferred
MBA preferred
Company
Alignment Health
Alignment Health provides eldercare services.
501-1000 employees
H1B Sponsorship
Alignment Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (3)
2024 (12)
2023 (17)
2022 (13)
2021 (11)
2020 (6)
Funding
Current Stage
Public CompanyTotal Funding
$696.05MKey Investors
K2 HealthVenturesWarburg PincusGeneral Atlantic
2024-11-15Post Ipo Debt· $321.05M
2024-01-09Private Equity
2021-03-26IPO
Leadership Team
Dawn Maroney
President, Alignment Health | CEO, Alignment Health Plan
John Kao
CEO and Founder
Recent News
Alignment Healthcare USA, LLC
2025-10-31
Alignment Healthcare USA, LLC
2025-10-14
Company data provided by crunchbase