Job Details

ID #19597979
State Ohio
City Dublin
Job type Permanent
Salary USD TBD TBD
Source Amerihealth
Showed 2021-09-14
Date 2021-09-02
Deadline 2021-11-01
Category Et cetera
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Coordinator Provider Network

Ohio, Dublin, 43017 Dublin USA

Vacancy expired!

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 www.amerihealthcaritas.com.

Responsibilities: Responsible for addressing provider issues and maintaining the provider tracking databases. In addition, the Network Coordinator supports the Network Management Department by assisting with root cause analysis and/or the development of reports, and other support activities related to monitoring the accuracy of provider contract configuration and resolution of provider issues.
  • Serves as a resource to Network Management Account Executives for contracting and provider set up questions/issues.
  • Assists the Contract Management Coordinator as necessary to assess issues/problems being encountered by providers and staff.
  • Responsible for Provider demographic management which includes additions, deletions or corrections and initial provider loads to Provider Maintenance.
  • Responsible for panel adds, holds and changes, member reassignments and member interventions as requested from Providers as mandated by State.
  • Responsible for the PMP/PCP Add and Terms with the State, as mandated by State.
Responsible for updating the provider contract database with new information or modifications to existing provider contracts accurately and within established timeframes.

Education/Experience:
  • Associate Degree or equivalent combination or education and work experience in a Health Care Field preferred.
  • Associate's Degree - preferred.
  • Minimum 1 - 2 years' experience in member, provider and/or finance operations in a healthcare or Managed Care Organization
  • 1-2 years' experience in customer service
  • 1-2 years business analyst experience preferred.
  • 1-2 years Medicaid experience preferred.
  • 3-5 years Office experience.
  • Proficiency with Microsoft Office Suite (Word, Excel, Power Point). Access is a plus. Consistent word processing speed and accuracy of 50 or more words per minute.

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