Coordinator Provider Network

Amerihealth Caritas•Newark, DE

21h•Remote

About The Position

The Coordinator provides support to the Provider Network Management team through administrative tasks and coordination efforts. The role supports network development and management, provider satisfaction, education, and communication, and helps maintain provider information and resolve provider issues. This position is fully remote, but the Associate must be located in Delaware to attend in-office meetings as needed.

Requirements

Associate’s degree.
At least 1 year of experience.
Must be located in Delaware to attend in-office meetings as needed.

Responsibilities

Support network development and network management strategies.
Assist the Leader with departmental activities related to provider satisfaction, education, and communication.
Support intake and management of provider issues, including maintaining provider tracking databases as applicable.
Identify and develop suggestions for provider participants’ improvement or action plans, and assist providers in developing, implementing, monitoring, and tracking improvement activities.
Perform secretarial, administrative, and clerical duties for Provider Network Management staff as applicable, including providing efficient administrative support to the department.
Serve as a resource to Network Management Account Executives on lower-complexity contracting and provider setup questions or issues.
Assist with scheduling appointments for plan participation and provider meeting attendance as needed.
Prepare provider demographic management updates, including additions, deletions, corrections, and initial provider loads for Provider Network Operations or Provider Enrollment Services.
Prepare and coordinate panel additions, holds, and changes; member reassignments; and member interventions requested by providers as mandated by state requirements, as applicable.
Apply general operational knowledge related to provider satisfaction, education, and communication, with a fundamental understanding of claims, payment integrity, provider data, credentialing, appeals, and disputes.
Update the provider contract database accurately and within established timeframes with new information or modifications to existing provider contracts.