Coordinator Provider Network Operations Sr

Your career starts now. We''re looking for the next generation of health care leaders.At AmeriHealth Caritas, we''re passionate about helping people get care, stay well and build healthy communities. As one of the nation''s leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we''d like to hear from you.Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at Responsibilities:The Senior Provider Network Operations Coordinator is an experienced professional who serves as the subject matter expert (SME) in the New Business Operations team for all coordinators and temporary staff on data requirements, data-gathering processes and new market development sessions for enterprise systems. Responsible for activities related to the provider recruitment and contracting databases, including but not limited to the following: database maintenance, data extraction, analyses and reporting data for internal and external stakeholders, and database improvement. The senior coordinator works closely with the supervisor and/or manager to assure the policies, procedures and state-specific nuances are followed through and implemented for every new or existing LOB. S/he will also participate in producing deliverables and reporting from special software programs. Build and prepare the provider profiles for enterprise systems in support of new business activities and new market implementations to assure data accuracy, data maintenance and data retrieval of provider information and provider contracts. Other accountabilities/responsibilities:Data review for accuracy and completeness of all documents during the provider recruitment to the provider contracting process, such as, Letters of Intent (LOIs), Letters of Agreement (LOAs), contracts and/or credentialing information.Ensure accurate entry and proper maintenance of provider data.Knowledge and application of market implementation data rules and processes applied to data management.Meet the business project timelines and milestones, make decisions regarding implementation.Knowledge of and ability to manage, modify and update Contract Manager database , operating system (such as, FACETS) and other enterprise systems for new and existing markets.Work daily workflow queue in any enterprise system (such as, EXP MACCESS ) used for provider information-gathering, updates and maintenance.Work and maintain inventory in queue based on project/assignment priorities.Serve as the lead coordinator in project and assignment as appropriate.Education/ Experience: High School/GED.Associate''s Degree.Associate Degree or equivalent combination or education and work experience in a Health Care Field preferred.Minimum 3-5 years of experience in member, provider and/or finance operations in a healthcare or Managed Care Organization.Minimum of 2 years Medicaid experience preferred.Proficiency in Microsoft Access, Excel, and Sharepoint required.Some SQL experience preferred. BackShareApply Now

Created: 2021-11-29