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60 Avmed Provider Network Manager Jobs Hiring Near You

Zeeland Public Schools

Network Manager

Zeeland, MI · On-site

In conjunction with the Director of Educational Technology, the Network Manager will learn the needs of the district to provide network integrity and great customer service. Responsibilities: * Align ...

Zeeland Public Schools

Network Manager

Zeeland, MI · On-site

In conjunction with the Director of Educational Technology, the Network Manager will learn the needs of the district to provide network integrity and great customer service. Responsibilities: * Align ...

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Coordinator Provider Network

AmeriHealth Caritas Health Plan

Baton Rouge, LA • On-site

$18.50 - $25/hr

Full-time

Medical, Retirement, PTO

Posted 15 days ago

AmeriHealth Caritas rating

8.3

Company rating: 8.3 out of 10

Based on 73 frontline employees who took The Breakroom Quiz

132nd of 315 rated insurance

Job description

For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement.
Your career starts now. We're looking for the next generation of health care leaders.
At AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care 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'd like to hear from 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.
Role Overview:
The Provider Network Coordinator provides essential operational and administrative support to the Provider Network Management team and providers by coordinating, ensuring accurate data management, resolving issues, tracking activities, and executing initiatives related to provider network development, provider satisfaction, education, communication, and ongoing network operations.
Work Arrangements:
  • Hybrid - Associate must be located in Louisiana (LA)

Responsibilities:
  • Support provider network development and management strategies through coordination, tracking, and follow-up activities.
  • Assist leadership with departmental initiatives related to provider satisfaction, education, and communication.
  • Support the intake, tracking, and management of provider issues, including maintaining provider tracking databases as applicable.
  • Help create processes that support continuous improvement, including identifying improvement opportunities and assisting providers with developing, implementing, monitoring, and tracking action plans.
  • Perform a variety of administrative and clerical duties to support Provider Network Management staff, ensuring efficient daily operations.
  • Serve as a resource to Network Management Account Executives for lower-complexity contracting, provider setup questions, and issue resolution.
  • Verify and update provider demographics, this information, and assist with status updates.
  • As applicable, prepare and coordinate panel adds, panel holds, changes, member reassignments, and member interventions in accordance with state requirements.
  • Maintain a general operational understanding of provider-related processes, including claims, payment integrity, provider data management, credentialing, appeals, and dispute resolution.
  • Update and maintain the provider contract database, ensuring accuracy and adherence to established timelines.

Education & Experience:
  • High school diploma or GED required.
  • Associate's degree preferred.
  • 1 year of experience in healthcare/managed care operations, provider services, network management, or an administrative support role required.

Skills & Abilities:
  • Strong organizational and coordination skills with attention to detail.
  • Ability to manage multiple tasks and priorities in a fast-paced environment.
  • Effective written and verbal communication skills.
  • Ability to work collaboratively with internal teams and external provider partners.
  • Basic understanding of healthcare operations, particularly provider networks, claims, credentialing, and enrollment processes.
  • Proficiency with databases, tracking tools, and Microsoft Office applications.
  • Problem-solving mindset with the ability to escalate issues appropriately.
  • Strong customer service orientation with a focus on provider satisfaction.

Our Comprehensive Benefits Package
Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.
Our Comprehensive Benefits Package
Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

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