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Network Coordinator

Company: One Call
Location: Tallahassee
Posted on: June 22, 2022

Job Description:

Network Coordinator Under the supervision of the Supervisor/Manager, Network Operations. the Network Coordinator is responsible for various activities related to the Network Operations department, including experience in Medical Provider Network database integrity, Provider relations, Network Concierge and Provider Contracting and Credentialing activities. - Responsibilities: This includes, but is not limited to, executing the activities for the development of Medical Provider Networks (MPNs), Provider Network development, Provider contracting and credentialing strategies and establishing a sufficient network of participating providers to serve the health care network requirements of Harbor 's Clients. Advise in preparation of provider contracts. Be responsible for the quality maintenance of all provider data. This position is primarily responsible for Provider Network activities with Harbor MPNs. Responsibilities include (but not limited to): Onsite client meetings, Client Training, and the timely resolution of any Client-related request activities, in addition, this position will also support OCCM, by representing Harbor at joint client meetings, providing subject matter expertise support. General Responsibilities:

  • Network Coordinators maintain Medical Provider Networks (MPN), ensure provider network database integrity, and responsible for corrective activities to clean the provider database.
  • Responsible to ensure the most current provider data to ensure the quality of the network.
  • Oversees/handles Provider Validation activities, including telephonically contact assigned providers and validate required data elements.
  • Maintains MPNs and provider network databases with impeccable accuracy.
  • Handle Provider Relations activities and resolves provider service and data related issues.
  • Manages MPN client provider nominations against known network sources.
  • Contracts with providers that are nominated by Harbor clients as well as providers deemed to be necessary to maintain a viable network solution.
  • Performs other duties as requested or assigned.
  • Act as an operational resources as well as a primary Network Operations point of contact for clients.
  • Ensure client expectations are met (exceeded) in a quality manner and on a timely basis.
  • Assist with the process and workflow for preparation and negotiations of provider contracts and oversee negotiations of contracts in concert with provider contracting strategies.
  • Assist with the maintenance of all provider contracts templates and provider data whether directly contracted or through a leased PPO network relationship.
  • Assist Management wit the network development team activities to produce timely and positive results.
  • Conduct provider network gap analysis and fill areas that shortages exist or work with contracting staff and client to identify contracting opportunities.
  • Train designated team members.
  • Provide timely handling and completion of assigned projects. Provide regular and timely reports for all assigned projects.
  • Improve the efficiency of the Network Operation process and procedures - to enhance quality and efficiency.
  • Prepare client-related/requested Stewardship reports on a timely basis.
  • -Responsible for knowledge of State regulations which impact the Provider Networks (e.g. California-MPN regulations, etc.).
  • Provide timely and accurate submission al of all company requested projects, assignments and reports. Knowledge, Skills and Abilities:
    • Strong oral and written communication skills and the ability to effectively communicate with others in a professional environment.
    • Ability to work on several projects simultaneously with excellent organizational skills.
    • Strong problem-solving skills.
    • General Computer literacy, including proficiency in MS Office suite of products (Word, Excel, PowerPoint, Outlook). Employment at One Call Care Management will be contingent upon your completion and our evaluation of a drug screen and criminal background check. EOE

Keywords: One Call, Tallahassee , Network Coordinator, Other , Tallahassee, Florida

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