Cecilia Galeana
Downey,CA
Summary
Results-driven professional with extensive experience in provider relations and strategic planning. Demonstrated success in building strong provider networks and resolving complex issues, ensuring alignment between contracted providers and internal teams. Eager to leverage expertise to foster growth and enhance operational performance.
Overview
2026
2026
years of professional experience
Work History
IPA Administrator
Prospect Medical Systems
Orange, California
2003 - Current
- Support departmental strategic initiatives by monitoring network financial and operational KPIs, developing reports and resources to track performance, trends, and opportunities for improvement.
- Collaborate cross-functionally with contracting, quality, operations, finance, and business development teams to align provider network strategy with organizational goals.
- Oversee provider relations operations and staff performance while serving as a key liaison between contracted providers and internal stakeholders to resolve complex operational, contractual, and financial issues.
- Previously led provider network growth initiatives as Director, identifying and executing standard, semi-exclusive, and exclusive PCP contracts, recruiting specialists, and ensuring networks remained market-competitive to drive membership growth.
- Conducted business development activities to support growth, including PCP recruitment, broker outreach, health plan and broker meetings, marketing strategies, senior, and commercial events, and successful integration of four acquisitions.
Regional Network Manager
Latino Health Care
Long Beach, California
2000 - 2002
- Led strategic development and expansion of hospital, PCP, specialty, and ancillary provider networks, including contract negotiations, credentialing, and health plan submissions.
- Directed the managed care division (network development, provider services, contracting, credentialing), developing compliant policies, provider orientation programs, executive reporting, and training, while managing staff performance in partnership with compliance leadership.
Provider Relations Representative
Tower Health Plan
Long Beach, California
1998 - 2000
- Served as the primary liaison to contracted MSOs/IPAs, hospitals, and ancillary providers, maintaining strong relationships and coordinating issue resolution across internal departments.
- Managed day-to-day provider relations operations, including provider data updates, training and in-servicing, policy interpretation, and creation of provider communications (bulletins, newsletters), while supporting network growth through marketing events.
Network Operations Representative
IMC Management
Riverside, California
1994 - 1998
- Supported network operations across departments by managing provider databases, producing standardized reports, and preparing for health plan audits (utilization management, claims, and credentialing).
- Led provider-facing initiatives, including orientations, facility site reviews, and marketing events, to support network growth and compliance.
Education
San Bernardino Valley College
San Bernardino, CABachelor of Science - Psychology
California State University, Fullerton
Fullerton, CASkills
- Contract negotiation
- Claims resolution
- Network expansion
- Credentialing processes
- Strategic planning
- Microsoft Office
Languages
English
Native/ Bilingual
Spanish
Native/ Bilingual
Timeline
IPA Administrator
Prospect Medical Systems
2003 - Current
Regional Network Manager
Latino Health Care
2000 - 2002
Provider Relations Representative
Tower Health Plan
1998 - 2000
Network Operations Representative
IMC Management
1994 - 1998
San Bernardino Valley College
Bachelor of Science - Psychology
California State University, Fullerton