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Network Management Coordinator - Temporary in Orange at Prospect Medical Systems

Date Posted: 1/3/2019

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    Orange
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    1/3/2019
  • Job ID:
    11399

Job Description



Network Management 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.

High paced telephone representative supporting Providers and the Provider Relations Department. Duties include provider education regarding our provider web portal, provider orientations, compliance training and claim, referral and eligibility troubleshooting via phone, e-mail or fax.  Includes report management, data entry, mail merge and formatting projects on Word and Excel.  Candidate must have strong research skills, highly organized with time management and project management skills.  Works well under pressure while maintaining pleasant phone etiquette.  Works independently and in a team environment.  Must have Provider Relations or Customer Service experience. Proficient in Excel and Word. Working knowledge of IDX (internal operating system), Aerial Care (online provider portal) and Office Ally (claims clearinghouse) or comparable systems preferred.



Job Responsibilities/Duties

  • Support Network Management Department tasks including initial set-up, routine servicing, maintenance, training, retention and membership growth initiatives.

  • Adhere to Prospect Medical Policies and Procedures and conduct telephonic trainings and proactive routine outreach to physician offices.

  • Responsible for answering incoming (direct or hunt group) calls and conducting outgoing telephone calls to Providers as needed.

  • Individual will act as a resource for team members while maintaining a positive attitude and interacting well with individuals on all levels.

  • Handle incoming and outgoing e-mail and fax inquiries, answer internal and external calls and conduct outgoing telephone calls to provider offices, internal staff and external vendors to provide assistance or resolution.

  • May assist with gathering data for resolutions to claims and capitation/fee for service payment inquires and special projects. 

  • Document all telephone calls, correspondence and e-mails pertaining to Network Management Provider Relations from Providers and internal staff inquiries in our IDX system and provide timely and thorough responses to all requests received as per Network Management Policies & Procedures.

  • Comply with production report requirements as stated in Network Management Provider Relations Department Policies and Procedures.  

  • Perform business development and event coordination functions on and off-site to support Network Management team with membership growth activities and provider engagement.



Qualifications

Minimum Education: High school diploma or equivalent. 

Minimum Experience: Minimum three (3) years of IPA/HMO setting or equivalent experience in managed care. Three (3) years in Provider or Customer Relations.

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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