Highlights
Responsible for preparing Provider demographic management which includes additions, deletions or corrections and initial provider loads to Provider Network Operations/Provider Enrollment Services. + 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.
Numbers & Facts
| Location | Newark, DE (Remote) |
| Industry | Healthcare Services |
| Company Size | 5,000 to 9,999 employees |
| Year Founded | 1985 |
| Website | http://www.amerihealthcaritas.com |
Description
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.
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.
About Company
Leaders in health care solutions for those most in need
AmeriHealth Caritas is the nation's leader in providing comprehensive health care solutions for those in most need and the chronically ill. We impact the lives of more than 5.7 million members nationwide. With more than 30 years of experience managing care for individuals and families in publicly-funded programs, we have become known for developing innovative solutions that help improve health outcomes while reducing costs.
Our mission, our goal
Our mission is to help people get care, stay well and build healthy communities. Our goal is to provide responsible managed care solutions, including Medicaid, Medicare, and CHIP - plus behavioral health, pharmacy benefits management and third-party management and administrative services.