Provider Services Advocate in Redlands, California at LSMA Management Inc

JOB SUMMARY

The Provider Services Advocate serves as a primary liaison between a California-based Independent Practice Association (IPA) and its contracted provider network (primary care, specialists, ancillary providers, and clinic staff). This role supports provider satisfaction and operational performance by resolving provider inquiries, educating offices on IPA processes (authorizations, referrals, claims/payment, eligibility, and delegated functions), and facilitating issue resolution across internal departments and external partners. The Advocate conducts routine and as-needed clinic visits—including travel to the Low Desert area—to strengthen relationships, reinforce standards, and identify improvement opportunities that enhance access, quality, and service.

MINIMUM & PREFERRED QUALIFICATIONS

Education

Minimum: High school diploma or GED required.
Preferred: Bachelor's degree in healthcare administration, public health, or related field.

Experience

Minimum: At lease two years of experience in managed care, healthcare administration, MSO, IPA, medical group, health plan, or provider office environment.

Preferred: Experience supporting provider relations, claims, credentialing, or health plan operations. Experience working in California managed care environment. Experience working with MSO, IPA, or delegated managed care operations.

Skills, Knowledge, and Abilities

• Knowledge of managed care operations, provider networks, and healthcare delivery systems.
• Knowledge of claims processing, eligibility, and credentialing processes.
• Knowledge of Medicare, Medi-Cal, Commercial, PPO, and HMO plan structures.
• Strong customer service and provider support skills.
• Excellent verbal and written communication skills.
• Strong problem-solving and analytical skills.
• Ability to manage multiple tasks and prioritize workload.
• Strong attention to detail and organizational skills.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook).
• Ability to maintain confidentiality and handle sensitive information
• Ability to work independently and collaboratively in a team environment.

PHYSICAL, MENTAL, & ENVIRONMENTAL REQUIREMENTS

The physical, mental, and environmental demands described here are representative of those required to successfully perform the essential functions of this job. Work is primarily performed in a standard office or hybrid office environment and requires prolonged periods of sitting, computer use, and telephone communication. The role requires sustained attention to detail, problem-solving, and multitasking to resolve provider issues efficiently. Occasional lifting or moving of materials up to approximately 15–20 pounds may be required. The position requires the ability to communicate effectively with providers, staff, and external partners while maintaining professionalism and confidentiality.