Coordinator provider network

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 located in Delaware (DE) to attend in office meeting as needed.

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.