Coordinator Provider Network

AmeriHealth Caritas • Newark, DE • 50min ago

Role Overview: The primary responsibility of the Coordinator is to provide support to the Provider Network Management team as it relates to tasks and coordination efforts needed.

Work Arrangement:

Remote - This position is fully remote.The Associate must be able to attend in-office meeting at our Delaware (DE) office.

Responsibilities:

Supports network development and network management strategies.

Responsible for assisting the Leader with departmental activities related to provider satisfaction, education, and communication.

Supports intake and management of provider issues in maintaining the provider tracking databases, as applicable.

Creates infrastructure for continuous improvement by identifying and developing suggestions for provider participant's improvement/action plans and assist providers in developing, implementing, monitoring, and tracking of improvement activities.

As applicable, performs a variety of secretarial, administrative, and clerical duties for the staff of Provider Network Mgt department; including, but not limited to, responsibility for the efficient administrative support of the department.

Serves as a resource to Network Management Account Executives for lower complexity contracting and provider set up questions/issues.

Assist with scheduling appointments for plan participation and attendance for provider meetings, as needed.

Responsible for preparing Provider demographic management which includes additions, deletions or corrections and initial provider loads to Provider Network Operations/Provider Enrollment Services.

As applicable, responsible for preparing and coordinating panel adds, holds and changes, member reassignments and member interventions as requested from Providers as mandated by State requirements

General Operational Knowledge related to provider satisfaction, education and communication with a fundamental understanding of operational items such as claims, payment integrity, provider data, credentialing, appeals disputes etc.

Responsible for updating the provider contract database with new information or modifications to existing provider contracts accurately and within established timeframes.

Education & Experience:

Associate's degree.

1 or more years of experience.

As a company, we support internal diversity through:

Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.

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