Coordinator Provider Network

Company: AmeriHealth Caritas
Location: Manchester
Posted on: January 25, 2023

Job Description:

Coordinator Provider NetworkLocation: Manchester, NHPrimary Job Function: Medical ManagementID**: 27124Your career starts now. Were looking for the next generation of health care leaders.At AmeriHealth Caritas, were 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, wed 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:The Coordinator, Provider Network Operations reports directly to the Director, Provider Network Operations and supports the Provider Network Operations team in managing Plan operational functions and activities; key responsibilities include:

• Coordinating and facilitating administrative activities including meetings and material development (P&Ps, desk procedures, workflows, etc.)
• Assessing and triaging incoming provider issues while maintaining tracking database(s) and ensuring that operational issues are being worked and resolved in a timely manner
• Preparing high-visibility reports that outline the operational status of key provider escalations and issues
• Assisting Provider Network Operations staff as necessary to assess and correct issues being encountered by providers and other internal staff; to include submitting requests to various operational areas via Service Form (SF), or other methods, to update provider information, run claim reports or projects, etc.
• Analyzing and trending reports to identify outliers and areas of improvement
• Managing and routing state requests and inquiries to appropriate functional areas while ensuring timely responses
• Assisting in drafting and/or finalizing formal correspondence to customers
• Engaging, developing and maintaining multiple customer relationships, establishing trust and open communicationEducation/Experience:
  • Associates Degree preferred or equivalent combination of education and work experience in a Health Care field preferred.
  • 3-5 years office experience.
  • Previous claims, healthcare, managed care or insurance industry environment preferred.
  • Must be proficient in Microsoft Office products.
  • Superior organizational skills required.
  • Critical thinking skills.
  • Billing and coding experience/knowledge a plus.
  • Strong customer service skills.
  • Excellent written and verbal communication.
  • Track record of Customer Excellence.
  • Demonstrated ability to coordinate activities across functional areas.
  • Sound personal management skills to plan, organize, schedule, and complete own work and work that is coordinated with others.EOE Minorities/Females/Protected Veterans/Disabled

Keywords: AmeriHealth Caritas, Manchester , Coordinator Provider Network, Other , Manchester, New Hampshire