Network Coordinator

Overview The Coordinator, Network Management is responsible for working as the internal liaison in maintaining, processing and reviewing department databases and reporting on a daily basis to assist the Network Management Department in meeting the overall network growth and development goals. Responsibilities Assist in network growth and development to include preparation of contract packets for recruitment projects. Work with Network Managers and providers to obtain proper signatures and documentation to effectively process newly recruited or existing providers. Maintain and update the appropriate databases and department tools with statuses. Coordinate receipt and processing of all provider contracts, credentialing, and correspondence. Ensure timely and accurate completion of PACFs related to incoming documentation from providers regarding changes to demographic information in the credentialing and provider network databases. Perform initial review of credentialing applications prior to submittal to RMG Contracts for completion and accuracy. Collaborate with Network Managers during the contracting process to ensure department goals and requirements are met. Submit provider profiles to Health Plans and follow up as requested to ensure PCPs are active in databases. Limited contract negotiations under the direction of the Director, Network Management and/or Vice President of Regional Operations. Interact daily with regional providers. Ensure contract compliance and adherence to DMHC, DHS, CMS and other regulatory agencies as required by contracting HMOs. Serve as the internal network liaison for Database, Claims, Customer Service, Medical Management, and Provider Relations Departments. Perform on-site visits to physicians, physician groups, hospitals and ancillary providers as required. Facilitate the scheduling of meetings with providers. Oversee database maintenance and accuracy through audits. Ensure accurate and timely data reporting requirements are met. Know and follow the Employee Handbook policies and procedures. Maintain patient confidentiality to observe HIPAA compliance at all times. All other duties as directed by management. Distribution of work Daily production will vary from day to day. All assigned work must be completed by the end of the business day to maintain turnaround time compliance. Special Projects Assist with any special projects. Compensation The pay range for this position at commencement of employment is expected to be between $22-$25 per hour; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, licensure, skills, and experience. The total compensation package for this position may also include other elements, including a sign-on bonus and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered. Details of participation in these benefit plans will be provided if an employee receives an offer of employment. If hired, employee will be in an “at-will position” and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors. About Regal As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare & Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success. Full Time Position Benefits The success of any company depends on its employees. For us, employee satisfaction is crucial not only to the well-being of our organization, but also to the health and wellness of our members. We are dedicated to providing our employees the options and resources necessary for building security and maintaining a healthy balance between work and life. Health and Wellness Employer-paid comprehensive medical, pharmacy, and dental for employees Vision insurance Zero co-payments for employed physician office visits Flexible Spending Account (FSA) Employer-Paid Life Insurance Employee Assistance Program (EAP) Behavioral Health Services Savings and Retirement 401k Retirement Savings Plan Income Protection Insurance Other Benefits Vacation Time Company celebrations Employee Assistance Program Employee Referral Bonus Tuition Reimbursement License Renewal CEU Cost Reimbursement Program Business-casual working environment Sick days Paid holidays Mileage Requirements Education and/or Experience: Minimum of 2 years relevant work experience in Network Management in a managed care setting, health plan or large medical group administration. Knowledge of contracting principles/tools. Excellent verbal and written communication skills. Proficient in MS Office programs (Word, Excel, Outlook, Access and PowerPoint) #J-18808-Ljbffr