2,427 Managing IT Infrastructure jobs in the United States
Network Management - Analyst

Posted today
Job Viewed
Job Description
As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
**Position Summary**
This position is an exciting opportunity to join a specialized team of auditors as part of CVS Caremark's extensive Pharmacy Audit division. The Medicare Pharmacy Claims Auditor will administer assigned Medicare Part-D Compliance Audit Programs, review pharmacy submitted Medicare claims, make independent decisions, and call network pharmacies to audit submitted information and communicate business requirements. Candidates will work with other auditors to successfully complete audit projects. Candidates must be highly motivated, possess strong communication skills, effective time-management skills, and be very detail-oriented. Candidates will become an expert on the CVS Health Medicare Audit Programs and will own one or more of those program processes on an ongoing basis. Candidates must possess extremely strong teamwork and collaboration skills and be skilled in sharing common workloads with peers. Candidates will have expansive opportunities to innovate and develop new tools to enhance the execution of audit programs, and work with internal and external partners to develop successful solutions within the scope of the processes for which they are accountable. This helps keep CVS Health plans in compliance with CMS requirements and maintain positive STAR ratings.
Daily Tasks may include:
-Telephone outreaches to network pharmacies to verify claim information.
-Transmission of audit requests to pharmacies.
-Review of hard copy prescriptions to verify compliance with CMS requirements and CVS Health contractual requirements.
-Review incoming documentation from pharmacies and input information into internal CVS Health audit systems.
-Corresponding with network pharmacies to answer questions regarding Medicare Audit Programs.
-Monitor assigned audit processes and report statuses on a regular basis.
-Meeting with internal partners to develop and communicate business objectives.
**Required Qualifications**
-1+ year(s) combined experience in a PBM or pharmacy.
**Preferred Qualifications**
-5+ years combined experience in PBM or pharmacy.
-2+ years experience in PBM or pharmacy claim processing systems.
-Familiarity with current CMS Medicare Part-D compliance regulations.
-Advanced level of technical skillsets including Microsoft Excel, Microsoft Access, and SQL databases.
-PTCB certification.
**Education**
Verifiable High School Diploma or GED required. Bachelor's Degree preferred.
**Anticipated Weekly Hours**
40
**Time Type**
Full time
**Pay Range**
The typical pay range for this role is:
$43,888.00 - $85,068.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
**Great benefits for great people**
We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
+ **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** .
+ **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
+ **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit anticipate the application window for this opening will close on: 11/10/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
Provider Network Management Director

Posted today
Job Viewed
Job Description
**Hours:** Monday - Friday
**Travel:** This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office.
**Position Overview:**
Develops the provider network through contract negotiations, relationship development, and servicing for large health systems and affiliated physician groups including employed, hospital based and hospital owned ancillary providers. Primary focus of this role is contracting and negotiating contract terms. Deals with only the most complex health systems, affiliated providers, and supports value base initiatives.
**How You Will Make an Impact:**
+ Serves in a leadership capacity, leading associate resources, special projects/initiatives, or network planning
+ Serves as a subject matter expert for local contracting efforts or in highly specialized components of the contracting process and serves as subject matter expert for that area for a business unit
+ Typically serves as lead contractor for large scale, multi-faceted negotiations
+ Serves as business unit representative on enterprise initiatives around network management and leads projects with significant impact
+ May assist management in network development planning to include gap fill projects and network adequacy reporting
+ May provide work direction and establish priorities for field staff and may be involved in associate development and mentoring
+ Contracts involve non-standard arrangements that require a high level of negotiation skills
+ Familiarity with customized Fee schedules
+ Works independently and requires high level of judgment and discretion
+ May work on projects impacting the business unit requiring collaboration with other key areas or serve on enterprise projects around network management
+ Serves as a communication link between providers and the company
+ Conducts the most complex negotiations
+ Prepares financial projections and conducts analysis
**Required Qualifications:**
+ Requires a BA/BS degree and a minimum of 8 years' experience in contracting (value based, shared savings and ACO development), provider relations, provider servicing; experience must include prior contracting experience; or any combination of education and experience, which would provide an equivalent background.
**Preferred Qualifications:**
+ Candidate Must reside in Kansas
+ Kansas Medicaid and Medicare strongly preferred
+ Advanced Negotiation skills is a must have
+ Experience using financial models and analysis to negotiate rates with providers strongly preferred
+ Value Based/Alternative payment model experience strongly preferred
+ Travels to worksite and other locations as necessary
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Provider Network Management Director

Posted today
Job Viewed
Job Description
**Location:** 740 W Peachtree St. NW. Atlanta GA. This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace.
_Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location will not be considered for employment, unless an accommodation is granted as required by law_
The **Provider Network Management Director** develops the provider network through contract negotiations, relationship development, and servicing for large health systems and affiliated physician groups including employed and hospital based, and hospital owned ancillary providers. The primary focus of this role is contracting and negotiating contract terms. Deals with only the most complex health systems, affiliated providers and drives and support value base initiatives.
**How you will make an impact:**
- Serves in a leadership capacity, leading associate resources, special projects/initiatives, or network planning.
- Serves as a subject matter expert for local contracting efforts or in highly specialized components of the contracting process and serves as subject matter expert for that area for a business unit.
- Typically serves as lead contractor for large-scale, multi-faceted negotiations.
- Serves as business unit representative on enterprise initiatives around network management and leads projects with significant impact.
- May assist management in network development planning.
- May provide work direction and establish priorities for field staff and may be involved in associate development and mentoring.
- Contracts involve non-standard arrangements that require a high level of negotiation skills.
- Fee schedules are customized.
- Works independently and requires high level of judgment and discretion.
- May work on projects impacting the business unit requiring collaboration with other key areas or serve on enterprise projects around network management.
- May collaborate with the sales team in making presentations to employer groups.
- Serves as a communication link between providers and the company.
- Conducts the most complex negotiations.
- Prepares financial projections and conducts analysis.
- Travels to worksite and other locations as necessary.
**Minimum Requirements:**
Requires a BA/BS degree and a minimum of 8 years of experience in contracting (value based, shared savings and ACO development), provider relations, provider servicing; experience must include prior contracting experience; or any combination of education and experience, which would provide an equivalent background.
**Preferred Skills, Capabilities and Experiences:**
- Experience using financial models and analysis to negotiate rates with providers is strongly preferred.
- Prior contract negotiation and financial analysis experience is strongly preferred.
- Strategic Thinking: Capability to align contract strategies with the organization's overall business goals and objectives preferred.
- Analytical Skills: Strong analytical skills to evaluate complex contracts, identify potential risks, and develop strategies to mitigate those risks is strongly preferred.
- Attention to Detail: High level of attention to detail to ensure accuracy and compliance with contracting processes is preferred.
- Problem-Solving: Ability to quickly identify issues and develop effective solutions is preferred.
- Communication Skills: Excellent verbal and written communication skills to clearly articulate contract terms and negotiate effectively with stakeholders is preferred.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Provider Network Management Director

Posted today
Job Viewed
Job Description
**Location:** This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered. Travels to worksite and other locations as necessary.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
The **Provider Network Management Director** is responsible for developing and managing the provider network through strategic contract negotiations, relationship development, and servicing for large health systems and affiliated physician groups, including employed, hospital-based, and hospital-owned ancillary providers. The primary focus of this role is contracting and negotiating complex terms with the most intricate health systems and affiliated providers, supporting value-based initiatives. This individual will bring comprehensive experience across all lines of business-including Medicare, Medicaid, and commercial and will have skill not only in contracting but also solid understanding of claims, pricing, and system configuration. The ideal candidate must possess contracting and negotiation experience involving $25 million or more. Additionally, they should have experience with executive presentations, possess a higher level of coordination, and be able to effectively engage with executive leadership, demonstrating seasoned executive presence.
**How you will make an impact:**
+ Serves in a leadership capacity, leading associate resources, special projects/initiatives, or network planning.
+ Serves as a subject matter expert for local contracting efforts or in highly specialized components of the contracting process and serves as subject matter expert for that area for a business unit.
+ Typically serves as lead contractor for large scale, multi-faceted negotiations.
+ Serves as business unit representative on enterprise initiatives around network management and leads projects with significant impact.
+ May assist management in network development planning.
+ May provide work direction and establish priorities for field staff and may be involved in associate development and mentoring.
+ Contracts involve non-standard arrangements that require a high level of negotiation skills.
+ Fee schedules are customized.
+ Works independently and requires high level of judgment and discretion.
+ May work on projects impacting the business unit requiring collaboration with other key areas or serve on enterprise projects around network management.
+ May collaborate with sales team in making presentations to employer groups.
+ Serves as a communication link between providers and the company.
+ Conducts the most complex negotiations.
+ Prepares financial projections and conducts analysis.
**Minimum Requirements:**
Requires a BA/BS degree and a minimum of 8 years' experience in contracting (value based, shared savings and ACO development), provider relations, provider servicing; experience must include prior contracting experience; or any combination of education and experience, which would provide an equivalent background.
**Preferred Skills, Capabilities, and Experience:**
+ Experience in healthcare contracting, with direct skill in negotiating with large providers and service vendors, strongly preferred.
+ Proven track record of successfully negotiating and managing provider contracts, with a comprehensive understanding of industry standards, billing codes, reimbursement mechanisms, and the regulatory landscape, strongly preferred.
+ Deep knowledge of Medicare, Medicaid, and Commercial business practices, strongly preferred.
+ Proven ability to negotiate complex contracts with payers, securing favorable terms for the organization, preferred.
+ Experience using financial models and analysis to negotiate rates with providers strongly preferred.
+ Exceptional strategic thinking, decision-making, problem-solving skills, and adaptability highly preferred.
+ Experience interacting confidently with senior management and executive level stakeholders, as a subject matter expert and comfortable with influencing decision-making preferred.
+ Excellent written, oral, presentation and interpersonal communication skills with the proven ability to negotiate expectations between multiple parties strongly preferred.
+ Proficient of Microsoft Office products Excel, Teams, Outlook, PowerPoint, and Word strongly preferred.
For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $16,380 to 182,160.
Locations: California
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws _._
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Provider Network Management Director

Posted today
Job Viewed
Job Description
**Location:** This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered. Travels to worksite and other locations as necessary.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
The **Provider Network Management Director** is responsible for developing and managing the provider network through strategic contract negotiations, relationship development, and servicing for large health systems and affiliated physician groups, including employed, hospital-based, and hospital-owned ancillary providers. The primary focus of this role is contracting and negotiating complex terms with the most intricate health systems and affiliated providers, supporting value-based initiatives. This individual will bring comprehensive experience across all lines of business-including Medicare, Medicaid, and commercial and will have skill not only in contracting but also solid understanding of claims, pricing, and system configuration. The ideal candidate must possess contracting and negotiation experience involving $25 million or more. Additionally, they should have experience with executive presentations, possess a higher level of coordination, and be able to effectively engage with executive leadership, demonstrating seasoned executive presence.
**How you will make an impact:**
+ Serves in a leadership capacity, leading associate resources, special projects/initiatives, or network planning.
+ Serves as a subject matter expert for local contracting efforts or in highly specialized components of the contracting process and serves as subject matter expert for that area for a business unit.
+ Typically serves as lead contractor for large scale, multi-faceted negotiations.
+ Serves as business unit representative on enterprise initiatives around network management and leads projects with significant impact.
+ May assist management in network development planning.
+ May provide work direction and establish priorities for field staff and may be involved in associate development and mentoring.
+ Contracts involve non-standard arrangements that require a high level of negotiation skills.
+ Fee schedules are customized.
+ Works independently and requires high level of judgment and discretion.
+ May work on projects impacting the business unit requiring collaboration with other key areas or serve on enterprise projects around network management.
+ May collaborate with sales team in making presentations to employer groups.
+ Serves as a communication link between providers and the company.
+ Conducts the most complex negotiations.
+ Prepares financial projections and conducts analysis.
**Minimum Requirements:**
Requires a BA/BS degree and a minimum of 8 years' experience in contracting (value based, shared savings and ACO development), provider relations, provider servicing; experience must include prior contracting experience; or any combination of education and experience, which would provide an equivalent background.
**Preferred Skills, Capabilities, and Experience:**
+ Experience in healthcare contracting, with direct skill in negotiating with large providers and service vendors, strongly preferred.
+ Proven track record of successfully negotiating and managing provider contracts, with a comprehensive understanding of industry standards, billing codes, reimbursement mechanisms, and the regulatory landscape, strongly preferred.
+ Deep knowledge of Medicare, Medicaid, and Commercial business practices, strongly preferred.
+ Proven ability to negotiate complex contracts with payers, securing favorable terms for the organization, preferred.
+ Experience using financial models and analysis to negotiate rates with providers strongly preferred.
+ Exceptional strategic thinking, decision-making, problem-solving skills, and adaptability highly preferred.
+ Experience interacting confidently with senior management and executive level stakeholders, as a subject matter expert and comfortable with influencing decision-making preferred.
+ Excellent written, oral, presentation and interpersonal communication skills with the proven ability to negotiate expectations between multiple parties strongly preferred.
+ Proficient of Microsoft Office products Excel, Teams, Outlook, PowerPoint, and Word strongly preferred.
For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $16,380 to 182,160.
Locations: California
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws _._
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Provider Network Management Director

Posted today
Job Viewed
Job Description
**Location:** This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered. Travels to worksite and other locations as necessary.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
The **Provider Network Management Director** is responsible for developing and managing the provider network through strategic contract negotiations, relationship development, and servicing for large health systems and affiliated physician groups, including employed, hospital-based, and hospital-owned ancillary providers. The primary focus of this role is contracting and negotiating complex terms with the most intricate health systems and affiliated providers, supporting value-based initiatives. This individual will bring comprehensive experience across all lines of business-including Medicare, Medicaid, and commercial and will have skill not only in contracting but also solid understanding of claims, pricing, and system configuration. The ideal candidate must possess contracting and negotiation experience involving $25 million or more. Additionally, they should have experience with executive presentations, possess a higher level of coordination, and be able to effectively engage with executive leadership, demonstrating seasoned executive presence.
**How you will make an impact:**
+ Serves in a leadership capacity, leading associate resources, special projects/initiatives, or network planning.
+ Serves as a subject matter expert for local contracting efforts or in highly specialized components of the contracting process and serves as subject matter expert for that area for a business unit.
+ Typically serves as lead contractor for large scale, multi-faceted negotiations.
+ Serves as business unit representative on enterprise initiatives around network management and leads projects with significant impact.
+ May assist management in network development planning.
+ May provide work direction and establish priorities for field staff and may be involved in associate development and mentoring.
+ Contracts involve non-standard arrangements that require a high level of negotiation skills.
+ Fee schedules are customized.
+ Works independently and requires high level of judgment and discretion.
+ May work on projects impacting the business unit requiring collaboration with other key areas or serve on enterprise projects around network management.
+ May collaborate with sales team in making presentations to employer groups.
+ Serves as a communication link between providers and the company.
+ Conducts the most complex negotiations.
+ Prepares financial projections and conducts analysis.
**Minimum Requirements:**
Requires a BA/BS degree and a minimum of 8 years' experience in contracting (value based, shared savings and ACO development), provider relations, provider servicing; experience must include prior contracting experience; or any combination of education and experience, which would provide an equivalent background.
**Preferred Skills, Capabilities, and Experience:**
+ Experience in healthcare contracting, with direct skill in negotiating with large providers and service vendors, strongly preferred.
+ Proven track record of successfully negotiating and managing provider contracts, with a comprehensive understanding of industry standards, billing codes, reimbursement mechanisms, and the regulatory landscape, strongly preferred.
+ Deep knowledge of Medicare, Medicaid, and Commercial business practices, strongly preferred.
+ Proven ability to negotiate complex contracts with payers, securing favorable terms for the organization, preferred.
+ Experience using financial models and analysis to negotiate rates with providers strongly preferred.
+ Exceptional strategic thinking, decision-making, problem-solving skills, and adaptability highly preferred.
+ Experience interacting confidently with senior management and executive level stakeholders, as a subject matter expert and comfortable with influencing decision-making preferred.
+ Excellent written, oral, presentation and interpersonal communication skills with the proven ability to negotiate expectations between multiple parties strongly preferred.
+ Proficient of Microsoft Office products Excel, Teams, Outlook, PowerPoint, and Word strongly preferred.
For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $16,380 to 182,160.
Locations: California
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws _._
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
IPA Network Management Coordinator

Posted today
Job Viewed
Job Description
Hourly Wage Estimate: $23.50 - $4.00 / hour
Learn more about the benefits offered ( ) for this job.
The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range.
**Introduction**
Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as a Managed Care Network Management Coordinator today with HCA Healthcare.
**Benefits**
HCA Healthcare offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:
+ Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
+ Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
+ Free counseling services and resources for emotional, physical and financial wellbeing
+ 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
+ Employee Stock Purchase Plan with 10% off HCA Healthcare stock
+ Family support through fertility and family building benefits with Progyny and adoption assistance.
+ Referral services for child, elder and pet care, home and auto repair, event planning and more
+ Consumer discounts through Abenity and Consumer Discounts
+ Retirement readiness, rollover assistance services and preferred banking partnerships
+ Education assistance (tuition, student loan, certification support, dependent scholarships)
+ Colleague recognition program
+ Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
+ Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.
Learn more about Employee Benefits ( Eligibility for benefits may vary by location._**
Come join our team as a Managed Care Network Management Coordinator. We care for our community! Just last year, HCA Healthcare and our colleagues donated 13.8 million dollars to charitable organizations. Apply Today!
**Job Summary and Qualifications**
The Network Management Coordinator is primarily responsible for maintaining the flow of documents and information within the Network Management Department.
DUTIES INCLUDE BUT NOT LIMITED TO:
+ Prepare correspondence, reports, rate proposals, special projects, presentations, project lists and other related material.
+ Handle telephone calls, mail and faxed correspondence.
+ Contact providers and/or provider office staff as needed to resolve issues.
+ Keep Department Supervisor informed of any complaints or issues as they arise.
+ Schedule, coordinate, and take minutes at meetings as required.
+ Interact daily with all departments within PPMSI, which include Customer Service, Utilization Management, Data Management and Network Management.
+ Work with the Credentialing Specialist to prepare documents for Membership meetings for SCCIPA and any other PPMSI client.
+ Maintain letter of interest tracking spreadsheets for SCCIPA and any other PPMSI Client.
+ Maintain strong relationships with contracted HMOs.
+ Communicate with payors and network providers, both orally and written, in association with operational and contractual related issues.
+ Update and maintains various databases utilized by Network Management.
+ Assist staff with report documentation and distribution.
+ Create and distribute provider updates to contracted HMOs.
+ Coordinate and facilitate special projects as assigned.
+ Order supplies for the department.
+ Handle business travel and meeting arrangements.
+ Perform other duties as assigned.
KNOWLEDGE, SKILLS AND ABILITIES: This position requires the following minimum requirements:
+ Able to prioritize duties effectively and remain flexible
+ Able to comply with policies and procedures and take direction well
+ Proficient in MS Word and Excel. Working knowledge of MS Access, and Adobe Acrobat
+ Excellent verbal and written communication skills
+ Extremely detail oriented and able to work well under pressure
EDUCATION:
+ High School Diploma
EXPERIENCE:
+ Minimum two (2) years' experience in an administrative support position
Physician Services Group ( is skilled in physician employment, practice and urgent care operations. We are experts in hospitalist integration, and graduate medical education. We lead more than 1,300 physician practices and 170+ urgent care centers. We are HCA Healthcare's graduate medical education leader. We provide direction for over 260 exceptional resident and fellowship programs. We focus on carrying out value-added solutions. These solutions help physicians deliver patient-centered healthcare. We support HCA Healthcare's commitment to the care and improvement of human life.
HCA Healthcare has been recognized as one of the World's Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $ .7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.
"The great hospitals will always put the patient and the patient's family first, and the really great institutions will provide care with warmth, compassion, and dignity for the individual."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder
If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Managed Care Network Management Coordinator opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. **Unlock the possibilities and apply today!**
We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
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Manager Provider Network Management
Posted 4 days ago
Job Viewed
Job Description
**Location: We are currently seeking people in the following counties and look forward to speaking with you! (Durand, Mondovi, Arcadia, Black River Falls, Neillsville, La Crosse, Sparta, Mauston, Viroqua, Baraboo Richland Center, Prairie du Chien, Platteville, Dodgeville, Darlington, Monroe, Milwaukee)**
**Field** : This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
The **Manager Provider Network Management** manages provider network contracting associates within a defined health service area.
**How you will make an impact:**
+ Effectively manages the analysts and contractors to meet or exceed the health care target costs on a per unit basis.
+ Must understand budget spends by hospital and by Primary and Specialty care practices and manage these contracts within budget constraints.
+ Responsible for contracting models, provider reimbursement, and risk modeling.
+ Hires, trains, coaches, counsels, and evaluates performance of direct reports.
**Minimum Requirements:**
+ Requires a BA/BS degree in a related field and a minimum of 5 years equivalent work experience in provider contracting; or any combination of education and experience, which would provide an equivalent background.
**Preferred Skills, Capabilities, and Experiences:**
+ Strongly preferred a minimum of 8 years provider data and project management experience.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Manager Provider Network Management
Posted 4 days ago
Job Viewed
Job Description
**Location: We are currently seeking people in the following counties and look forward to speaking with you! (Durand, Mondovi, Arcadia, Black River Falls, Neillsville, La Crosse, Sparta, Mauston, Viroqua, Baraboo Richland Center, Prairie du Chien, Platteville, Dodgeville, Darlington, Monroe, Milwaukee)**
**Field** : This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
The **Manager Provider Network Management** manages provider network contracting associates within a defined health service area.
**How you will make an impact:**
+ Effectively manages the analysts and contractors to meet or exceed the health care target costs on a per unit basis.
+ Must understand budget spends by hospital and by Primary and Specialty care practices and manage these contracts within budget constraints.
+ Responsible for contracting models, provider reimbursement, and risk modeling.
+ Hires, trains, coaches, counsels, and evaluates performance of direct reports.
**Minimum Requirements:**
+ Requires a BA/BS degree in a related field and a minimum of 5 years equivalent work experience in provider contracting; or any combination of education and experience, which would provide an equivalent background.
**Preferred Skills, Capabilities, and Experiences:**
+ Strongly preferred a minimum of 8 years provider data and project management experience.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Manager Provider Network Management
Posted 4 days ago
Job Viewed
Job Description
**Location: We are currently seeking people in the following counties and look forward to speaking with you! (Durand, Mondovi, Arcadia, Black River Falls, Neillsville, La Crosse, Sparta, Mauston, Viroqua, Baraboo Richland Center, Prairie du Chien, Platteville, Dodgeville, Darlington, Monroe, Milwaukee)**
**Field** : This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
The **Manager Provider Network Management** manages provider network contracting associates within a defined health service area.
**How you will make an impact:**
+ Effectively manages the analysts and contractors to meet or exceed the health care target costs on a per unit basis.
+ Must understand budget spends by hospital and by Primary and Specialty care practices and manage these contracts within budget constraints.
+ Responsible for contracting models, provider reimbursement, and risk modeling.
+ Hires, trains, coaches, counsels, and evaluates performance of direct reports.
**Minimum Requirements:**
+ Requires a BA/BS degree in a related field and a minimum of 5 years equivalent work experience in provider contracting; or any combination of education and experience, which would provide an equivalent background.
**Preferred Skills, Capabilities, and Experiences:**
+ Strongly preferred a minimum of 8 years provider data and project management experience.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.