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Sr. PIM Coordinator in Orange at Prospect Medical Systems

Date Posted: 9/28/2018

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    600 City Parkway West
    Orange
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    9/28/2018
  • Job ID:
    10737

Job Description



Sr. PIM 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.

This position acts as a liaison between our IPAs and contracted health plans and manages provider data. This position is responsible for reviewing quality assurance of rosters and data provided to the health plan, and that skills are continuously enhanced by ongoing education and training, answering questions regarding change forms, PIDs, and roster validation.



Job Responsibilities/Duties

  • Responsible for timely and accurate processing, of provider change forms.
  • Responsible for the submissions to contracted health plans for applicable network(s).
  • Responsible for provider listing maintenance and follow-up with health plans to ensure that all submissions have been processed appropriately.
  • Ensuring accuracy of provider information stored in database.
  • Management of requests/inquiries that come in from the health plans as well as from other Prospect Medical departments.
  • Responsible for the managing the data/rosters that is sent/received from Senator.
  • Responsible for validation of provider rosters; verifying the accuracy and ensuring roster is completed within the format requested by the specific health plan, and meeting health plans deadline.


Qualifications

Minimum Education: Bachelors in Business Administration or equivalent from a four year college or technical school.

Minimum Experience: Five years' experience and/or training in credentialing and/or contracting in a hospital or IPA setting.

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



10737

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