Managed Care Network Coordinator - Managed Care Operations - FT Days

University of California-Irvine • Irvine, CA

252d • $94,400 - $176,800

About The Position

UCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system based in Orange County. UCI Health is comprised of its main campus, UCI Medical Center, a 459-bed, acute care hospital in Orange, California, four hospitals and affiliated physicians of the UCI Health Community Network in Orange and Los Angeles counties, and ambulatory care centers across the region. Listed among America's Best Hospitals by U.S. News & World Report for 23 consecutive years, UCI Medical Center provides tertiary and quaternary care and is home to Orange County's only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program, and American College of Surgeons-verified Level I adult and Level II pediatric trauma center, gold level 1 geriatric emergency department, and regional burn center. UCI Health serves a region of nearly 4 million people in Orange County, western Riverside County, and southeast Los Angeles County. The position supports the Managed Care operations of UCI Health with respect to planning, development, and implementation of administrative and operational functions. The incumbent supports the various business operations needed to operate a capitated, delegated medical group providing service to managed care members. Services include implementation, oversight, health plan audits, reporting, engagement, and education of the contracted provider network. The incumbent will monitor and identify network gaps and assist in identifying providers including those needed for one-time agreements. The incumbent oversees customer service and member services and plays a critical role in understanding and implementing system improvement opportunities. The incumbent will establish methods for continuous monitoring/auditing of workflows to ensure the integrity and goals of the processes remain consistent and to identify potential opportunities for improvement.

Requirements

• Strong working knowledge of managed care concepts and medical management processes.
• Minimum of five (5) years previous experience in Provider Relations related to managed care.
• Extensive knowledge of managed care transaction systems such as EPIC (Tapestry Module), EZ Cap, etc.
• Excellent written and verbal communication skills in English.
• Demonstrated computer skills; proficient with Microsoft Windows applications including Excel, Word, and Outlook.
• Bachelor's Degree in Healthcare Administration, Business Administration or a related field, or equivalent combination of education and experience.

Nice To Haves

• Previous experience working in an academic medical setting.
• Knowledge of University and medical center organizations, policies, procedures, and forms.

Responsibilities

• Support the Managed Care operations of UCI Health.
• Plan, develop, and implement administrative and operational functions.
• Monitor and identify network gaps and assist in identifying providers.
• Oversee customer service and member services.
• Establish methods for continuous monitoring/auditing of workflows.

Benefits

• Medical insurance
• Sick and vacation time
• Retirement savings plans
• Access to discounts and perks

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Educational Services
• Education Level: Bachelor's degree