Provider Network Coordinator
Heritage Health Solutions
Department: Outside Medical Networks
Job Status: Full Time
FLSA Status: Non-Exempt
Reports To: Director, Provider Networks
Grade/Level: N/A
Amount of Travel Required: 0-5%
Work Schedule:
Positions Supervised: N/A
Generally, 8:00 AM to 5:00 PM, but may require some work outside of standard office hours.
POSITION SUMMARY
The Provider Networks Coordinator is responsible for collecting and storing provider information used to establish and maintain Provider Networks in various Geographic areas. Key focus of this position is Profit and Loss (P&L) for the Outside of the Walls Medical Networks Division and all operational aspects of the business unit. This requires planning, organization, and coordination of all work efforts and relationships with subcontractors. This position helps to ensure that all contract deliverables and performance standards are of the highest quality and results are delivered within contract parameters.
ESSENTIAL FUNCTIONS
Reasonable Accommodations Statement
To perform this job successfully, an individual must perform each essential duty satisfactorily. Reasonable Accommodations may be made to enable qualified individuals with disabilities to perform the essential functions. Essential Functions Statement(s)
Manage all in network provider information in various areas/databases
Monitor and Manage provider directories and make updates as needed
Distribute and communicate updated directory information to external customers
Obtain missing information from in network and out of network providers and enter into database
Collect credentialing documents from contracted providers and forward to credentialing team
Identify plan gaps and work with Director to recruit new specialists
Assist Director with preparing new provider contract Agreements and packets as needed
Assist Director with all operational resources and activities to operate within budget, maximize investments, increase effectiveness, and comply with all contract requirements
Maintain communication with appropriate customer contacts
Manage all direct communication efforts to ensure that contracted providers are aware of any changes
Maintain a high level of customer satisfaction
Attend and participate in conferences and meetings as directed
Maintain confidentiality of company business
Comply with HIPAA, Corporate Integrity, and HR policies
Complete and/or direct the timely delivery of all reports and invoices
Perform other job-related duties as required or directed Establish and implement essential departmental policies, goals, objectives, and procedures SKILLS & ABILITIES
Education: High School Diploma required; Bachelor’s Degree preferred
Experience: A minimum of 2 years’ experience in health care or contract administration required.
Vacancy posted 22 hours ago
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