Job Information
AmeriHealth Caritas Provider Network Coordinator in Philadelphia, Pennsylvania
Provider Network Coordinator
Location: Philadelphia, PA
Primary Job Function: Medical Management
ID**: 34226
Your career starts now. We are looking for the next generation of healthcare leaders.
At AmeriHealth Caritas, we are passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together, we can build healthier communities. If you want to make a difference, we would like to connect with you.
Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.
Discover more about us at www.amerihealthcaritas.com.
Responsibilities:
Responsible for addressing provider issues and maintaining the provider tracking databases. In addition, the Network Coordinator supports the Network Management Department by assisting with root cause analysis and the development of reports, as well as other support activities related to monitoring the accuracy of provider contract configuration and resolution of provider issues.
Serves as a resource to Network Management Account Executives for contracting and provider set-up questions/issues.
Assists the Contract Management Coordinator as necessary to assess issues/problems providers and staff encounter.
Responsible for Provider demographic management, including additions, deletions, corrections, and initial provider loads to Provider Maintenance.
Responsible for tracking State inquiries related to Provider escalations.
Responsible for the LTSS Home and Community Based Service (HCBS) Add and Terms with the State, as mandated by the State.
Responsible for updating the provider contract database with new information or modifications to existing provider contracts accurately and within established timeframes.
Education & Experience:
Associate degree or equivalent combination of education and work experience in a health care field is preferred.
Minimum of 1 to 2 years experience in member, provider, and finance operations in a healthcare or Managed Care Organization.
1 to 2 years of customer service experience.
1 to 2 years of business analyst experience preferred.
1 to 2 years of Medicaid experience preferred.
All Microsoft Office application, Facets, Navinet, HHA, and Promise systems.
Diversity, Equity, and Inclusion
At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
We keep our associates happy so they can focus on keeping our members healthy.
Our Comprehensive Benefits Package
Flexible work solutions include remote options, hybrid work schedules, competitive pay, paid time off, holidays and volunteer events, health insurance coverage for you and your dependents on Day 1, 401(k) tuition reimbursement, and more.
EOE Minorities/Females/Protected Veterans/Disabled