Network Operations Coordinator II
$47,500–$86,000 year
On-siteHouston, Texas, United States
Job Summary
Contract, credential, and maintain professional provider data to support marketing, membership, and network contracting across all lines of business. Promote high-quality initiatives to support data integrity while building relations with the provider community to accelerate their transition to value-based care. Serve as the primary contact for providers and staff to assist in contract management, provide supporting analyses for network optimization, and deliver materials on contracts, policies, and financial performance. Participate in internal provider meetings, research credentialing problems, perform root cause analyses for grievances, and track key performance metrics such as utilization and STARs. Prepare presentations for physician leadership and collaborate with internal departments to develop solutions for strategic business needs. Work onsite at provider offices three to five times weekly.
Required Qualifications
- Bachelor degree OR 4 years of experience in the Health Care industry
- 2 years of experience with Provider Network contracting and credentialing systems
- Written and verbal communication skills to interact with internal and external customers
- Analytical and quantitative skills
- Ability to take initiative and work independently
- Client-site Location: This is a field-based position. The individual will be onsite at provider offices 3-5 times weekly.
Desired Qualifications
- Subject Matter Expert for the Professional Provider Credentialing Process
- Experience with Microsoft Office applications including Excel, Access, and Power Point
- Previous HEDIS and/or CMS STARs experience
- Solid understanding of health insurance, customer messaging/design and project management
- Strong experience using Microsoft products, including Excel (knowledge of pivot tables, VLOOKUP, etc.) and PowerPoint
- Experience in financial/trend analysis
- Team player with proven ability to foster and manage working relationships within a matrix environment to obtain buy-in and drive results.
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