Provider Relations Coordinator
Provider Relations Coordinator
Employer Active
Job Alert
You will be updated with latest job alerts via email
Share
Job Alert
You will be updated with latest job alerts via email
Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
Location:
Calmont Operations BuildingDepartment:
Network MgmtShift:
First Shift (United States of America)Standard Weekly Hours:
40Summary:
Responsible for performing all physician hospital and ancillary provider orientation training and ongoing educational activities for CCHP network providers and their staffs. Responsible for the tracking of concerns complaints and issues raised by network providers and results reporting. Facilitates resolution of all complaints/issues raised by network providers related to members claims operational policies and organizational procedures. Responsible for ensuring the accuracy and completeness of CCHP provider directory information. Coordination of the development and publication of the CCHP provider newsletter. Development & maintenance of the CCHP provider reference guide. Develops and implements additional communications required to assure that CCHP providers are knowledgeable regarding CCHP operations and programs.Additional Information:
Responsible for performing all physician hospital and ancillary provider orientation training and ongoing educational activities for CCHP network providers and their staffs. Responsible for the tracking of concerns complaints and issues raised by network providers and results reporting. Facilitates resolution of all complaints/issues raised by network providers related to members claims operational policies and organizational procedures. Responsible for ensuring the accuracy and completeness of CCHP provider directory information. Coordination of the development and publication of the CCHP provider newsletter. Development & maintenance of the CCHP provider reference guide. Develops and implements additional communications required to assure that CCHP providers are knowledgeable regarding CCHP operations and programs.
Education & Experience:
- High School graduate with advanced training in healthcare business or a related field required.
- Five (5) years of operational experience in a managed care organization specifically in the area of provider network management to include provider orientation ongoing educational activities problem resolution and provider communications required.
- Previous experience with face-to-face visits to provider offices and traveling to designated providers offices based on territory assignments/counties required.
- Experience preparing and presenting information to individuals and groups.
- Experience with governmental managed care programs desired.
Knowledge Skills & Abilities:
- Incumbent must demonstrate proven success in establishing and maintaining positive working relationships with health care providers and their staffs.
- Working knowledge of HMO business operations specifically the functions of utilization management member services claims credentialing and benefit plan interpretation.
- Must be attentive to detail have excellent organizational problem solving verbal and written skills.
- Must be able to work independently and actively participate as an integrated team member.
Certification/Licensure:
- N/A
About Us:
Cook Childrens Health Plan
Cook Childrens Health Plan provides vital coverage to nearly 120000 people in low-income families who qualify for government-sponsored programs in our six county service region. Cook Childrens Health Plan provides health coverage for CHIP CHIP Perinatal STAR (Medicaid) and STAR Kids Members in the Tarrant county service area. The counties we serve includes Tarrant Johnson Denton Parker Hood and Wise.
Cook Childrens is an equal opportunity employer. As such Cook Childrens offers equal employment opportunities without regard to race color religion sex age national origin physical or mental disability pregnancy protected veteran status genetic information or any other protected class in accordance with applicable federal laws. These opportunities include terms conditions and privileges of employment including but not limited to hiring job placement training compensation discipline advancement and termination.
Required Experience:
IC
Employment Type
Full-Time
