Network Operations Coordinator

Clever Care Health Plan•Huntington Beach, CA

21h•$20 - $24

About The Position

The Network Operations Coordinator supports the Provider Network and Provider Configuration teams to maintain Provider Directory. They will help manage and validate all data in Quarterly Rosters received from all contracted groups.

Requirements

High school diploma required
Microsoft Excel knowledge and experience
Previous experience with data management
Demonstrated ability to manage multiple projects and meet deadlines
Strong communication and presentation skills with ability to effectively communicate with all levels of the organization, internally and externally
Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Responsibilities

Execute quarterly outreach to all contracted IPAs/Groups and organize accordingly.
Manage and maintain rosters for directly contracted hospitals and directly contracted acupuncturists.
Conduct roster validation which include but is not limited to license, NPI, and credentialing data.
Manage, store and validate attestations from delegated entities with each roster receival.
Provide internal communication and distribution to Provider Configuration and Network Analytics departments to support directory upload and network adequacy.
Properly notify and track all that each roster has been validated and properly distributed with Supervisor via bi-weekly meetings.
Conduct and log Access & Availability studies on a quarterly basis.
Distribute Type II PCP IDs to every IPA/Group monthly.
Provide Outreach and log for Absent Terminations from roster ingestion.
Same-day processing and tracking of all internal notification for immediate PCP terminations.