As part of the Corporate Provider Network Operations team, the Coordinator, Corporate Provider Network Operations bBuilds and prepares the provider profiles for enterprise systems in support of business activities and essentials for accuracy, maintenance and retrieval of provider data and contract requirements.
• Data review for accuracy and completeness of Letters of Intent (LOIs), Letters of Agreement (LOAs), contracts and/or credentialing information
• Accurate entry and proper maintenance of provider data
• Knowledge and application of market implementation data rules and processes
• Meet the business project timelines and milestones
• Knowledge of and ability to manage, modify and update Contract Manager database , operating system (such as, FACETS) and other enterprise systems for new and existing markets.
• Work daily workflow queue in any enterprise system (such as, EXP MACCESS ) used for provider information-gathering, updates and maintenance
• Work and maintain inventory in queue based on prioritization, aging and campaign
• Contribute to the effective operations of CPNO division
• Minimum 1 – 2 years experience in member, provider and/or finance operations in a healthcare or Managed Care Organization
• 1-2 years experience in customer service
• 1-2 years Medicaid experience preferred
• 1-2 years experience in business operations preferred