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Coordinator Provider Network

AmeriHealth Caritas

Southfield, MI(remote)

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JOB DETAILS
LOCATION
Southfield, MI
POSTED
5 days ago
Role Overview: The Provider Network Coordinator provides essential operational and administrative support to the Provider Network Management team and providers by coordinating, ensuring accurate data management, resolving issues, tracking activities, and executing initiatives related to provider network development, provider satisfaction, education, communication, and ongoing network operations.


Work Arrangement:


+ This position is fully remote and may be performed from anywhere within the state of Michigan (MI) during Eastern Standard Time (EST) hours.

+ Associates must have access to a reliable high‑speed internet connection capable of supporting daily responsibilities, with a minimum bandwidth of 50 Mbps download and 5 Mbps upload.

+ Fully remote associates residing in states where reimbursement is required by contract, law, or regulation may submit for appropriate expense reimbursement.


Responsibilities:


+ Support provider network development and management strategies through coordination, tracking, and follow‑up activities.

+ Assist leadership with departmental initiatives related to provider satisfaction, education, and communication.

+ Support the intake, tracking, and management of provider issues, including maintaining provider tracking databases as applicable.

+ Help create processes that support continuous improvement, including identifying improvement opportunities and assisting providers with developing, implementing, monitoring, and tracking action plans.

+ Perform a variety of administrative and clerical duties to support Provider Network Management staff, ensuring efficient daily operations.

+ Serve as a resource to Network Management Account Executives for lower‑complexity contracting, provider setup questions, and issue resolution.

+ Verify and update provider demographics, this information, and assist with status updates.

+ As applicable, prepare and coordinate panel adds, panel holds, changes, member reassignments, and member interventions in accordance with state requirements.

+ Maintain a general operational understanding of provider‑related processes, including claims, payment integrity, provider data management, credentialing, appeals, and dispute resolution.

+ Update and maintain the provider contract database, ensuring accuracy and adherence to established timelines.


Education & Experience:


+ High school diploma or GED required

+ Associate’s degree preferred

+ 1 year of experience in healthcare/managed care operations, provider services, network management, or an administrative support role


Skills & Abilities:


+ Strong organizational and coordination skills with attention to detail

+ Ability to manage multiple tasks and priorities in a fast‑paced environment

+ Effective written and verbal communication skills

+ Ability to work collaboratively with internal teams and external provider partners

+ Basic understanding of healthcare operations, particularly provider networks, claims, credentialing, and enrollment processes

+ Proficiency with databases, tracking tools, and Microsoft Office applications

+ Problem‑solving mindset with the ability to escalate issues appropriately

+ Strong customer service orientation with a focus on provider satisfaction
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 the Company

A

AmeriHealth Caritas

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.

COMPANY SIZE
5,000 to 9,999 employees
INDUSTRY
Healthcare Services
FOUNDED
1985
WEBSITE
http://www.amerihealthcaritas.com