Provider Network and Operations Coordinator

Trinity Health • MMCIA - MercyOne Mercy Health Network Central IA, IA

3d

About The Position

As an integral team member of MercyOne PHSO’s Operations team, the Provider Network and Operations Coordinator assists PHSO leadership on tasks as assigned. Functions including oversight and management for the MercyOne Provider Network Directory, Compliance & auditing, and coordination of projects. Serves as a liaison between PHSO administration, Chapters, regulatory bodies, and MercyOne Partnered Provider organizations/providers as needed. This role is part of the MercyOne PHSO Operations team, reporting to the Provider Network Supervisor.

Requirements

• Minimum of one year of experience with a healthcare system, health plan or healthcare accrediting body.
• Demonstrated proficiency in Microsoft applications (e.g., Word, Excel, PowerPoint) required.
• Strong demonstrated verbal communication and critical thinking skills required.
• Excellent verbal and writing skills required.
• Excellent organizational skills and attention to detail required.
• Ability to manage and prioritize multiple deliverables required.
• Must be comfortable operating in a collaborative, shared leadership environment.
• Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Trinity Health and MercyOne.

Nice To Haves

• Bachelor’s degree preferred. In lieu of educational requirements, previous work history and years of experience may be considered.
• Prior experience in project coordination preferred.
• Experience in ACOs and knowledge of value-based care is preferred.
• Excellent project management skills strongly preferred.
• Demonstrated presentation skills preferred.

Responsibilities

• Serves as the key resource to implement and maintain an accurate, NCQA-compliant Provider Network Directory.
• Develops and maintains intake/assessment forms to gather key information to support the Provider Network Directory.
• Coordinates with Medical Staff Offices, Physician Recruitment and Employment, and Clinic Managers to obtain all required information as part of recruitment processes.
• Assists in the management of PHSO Participant Agreements and Network Contracting.
• Assists in the investigation and response to member inquiries related to the Provider Network and Directory.
• Manages and monitors electronic Policy and Procedure handbook.
• Completes documentation and user audits according to federal and state health statutes, as well as third party control provisions.
• Assists the ACO Compliance Official in evaluating and responding to inquiries from governing bodies/regulatory agencies (i.e.: CHAN, Centers for Medicare and Medicaid Services).
• Assists in the on-boarding of new ACO Participants and Providers.
• Responds to PHSO email and phone inquiries from patients, providers and regulatory bodies.
• Assists with agenda creation, presentation of materials, and minutes for key meetings, including Provider Network Council and Chapter Governance Meetings.
• Assists PHSO leadership with special projects, including the tracking of deliverables, compiling information and reports, etc.
• Acts as resource in various committees and meetings to coordinate changes in ACO processes.
• Maintains PHSO directories, websites, and Sharepoint sites with education content.
• Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.

Benefits

• Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level