Coordinator Provider Network
AmeriHealth Caritas
Newtown Square, United States of America
4 days ago
Role details
Contract type
Permanent contract Employment type
Full-time (> 32 hours) Working hours
Regular working hours Languages
English Experience level
JuniorJob location
Remote
Newtown Square, United States of America
Tech stack
Databases
Microsoft Office
Network administration
Computer Network Operations
Data Management
Job description
- 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.
Requirements
- 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.
Benefits & conditions
Our Comprehensive Benefits Package
Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.
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.