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HMO Contract Project Coordinator in Orange at Prospect Medical Systems

Date Posted: 9/20/2018

Job Snapshot

Job Description



HMO Contract Project Coordinator

We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality healthcare services that are designed to offer our patients highly coordinated, personalized care and help them live healthier lives. Through collaboration, we strive to provide all of our patients and medical group members with the quality, affordable healthcare they need and deserve.

The HMO Contracting Project Coordinator is responsible for work with the  Contracting team and supports HMO Contracting Department in work flow processes and project management. Act as liaison with various internal departments and Health Plans to facilitate and resolve claim, system, customer service and other related contracting issues.  



Job Responsibilities/Duties

  • Supports contracting department by managing Health Plan Joint Operations Meetings:  schedule, monitor and create agenda items and ensure follow-up action items are completed timely by internal and external staff.

  • Creates, maintains and updates contract summaries with current, accurate contract and demographic information. Distributes to impacted departments timely.

  • Receives, assigns and tracks all Health Plan inquiries to completion with eye to time sensitivity.

  • Responsible for the HMO Contracting email box and answering and resolving urgent questions or urgently needed information.

  • Responsible for completing DMHC “possible termination” forms upon request of Health Plans.

  • Responsible for researching claim or benefit issues as needed.

  • Responsible for maintaining and updating FRMs for owned and managed groups.

  • Manages department projects as assigned.


Qualifications

Minimum Education:  Bachelor's degree or equivalent education and experience required.

Minimum Experience:  Three (3) year contracting experience related to health care or managed care environment.

Req. Certification/Licensure: None



Employee Value Proposition

Prospect Medical Holdings, Inc., is guided by a diverse and highly experienced leadership core. This group maintains the vision that has made Prospect a needed difference-maker in the lives of so many patients today, and many executives contribute to our continued efforts. As a member of our highly effective team of professionals you will receive:

  • Company 401K
  • Medical, dental, vision insurance
  • Paid time-off
  • Life insurance


How to Apply

To apply for this role, or search our other openings, please visit   http://pmh.com/careers/  and click on a location to begin your journey to a new career with us!

We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources.

EEOC is the Law: https://www1.eeoc.gov/employers/poster.cfm

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