Network Integrity Program Coordinator

AllCare Health, Inc.; Grants Pass (OR); On-site; USD 33,062 - 35,817; Full time

Benefits offered by this job

Mileage reimbursement

Cell phone stipend

Job summary

AllCare Health, Inc. is seeking a Network Integrity Program Coordinator in Grants Pass, Oregon. This role involves ensuring provider network adequacy and compliance with regulatory agencies, including OHA and CMS. Responsibilities include auditing network standards, preparing regulatory reports, and collaborating across teams to resolve network issues.

The ideal candidate will have a high school diploma, with 2-4 years of relevant experience in healthcare compliance and data analysis, along with exceptional skills in communication and organization.

Qualifications

• Two to four years of experience in healthcare provider network management or regulatory compliance.
• Ability to perform job duties with reasonable accommodations if needed.

Responsibilities

• Assist with provider network adequacy audits.
• Oversee audit preparation and submission processes.
• Monitor regulatory updates affecting network adequacy.

Skills

Healthcare knowledge

Writing and editing skills

Organization

Time management

Data analysis

Customer service

Education

High school diploma or GED

Tools

Microsoft Office Suite

Job description

AllCare Health Headquarters, Grants Pass, OR, US
6 days ago Requisition ID: 1207
Salary Range: $24.00 to $26.00 hourly

Summary of the Position

The Network Integrity Program Coordinator helps ensure provider network adequacy and compliance with regulatory requirements from the Oregon Health Authority (OHA), Centers for Medicare & Medicaid Services (CMS), and other relevant agencies. The role is responsible for implementing initiatives related to provider network access standards, monitoring network reports and dashboards, and assisting with regulatory audits. By collaborating with internal teams and regulatory agencies, the Program Coordinator works to enhance network adequacy, regulatory compliance, and DSN performance.

Job Duties

• Assist with provider network adequacy audits conducted by OHA, CMS, and other regulatory bodies; ensure compliance with applicable standards.
• Oversee the preparation, submission, and response processes for provider‑related audits, partnering with compliance, legal, and operational teams.
• Monitor regulatory updates and policy changes impacting network adequacy; implement necessary adjustments.
• Deliver precise and timely reports of provider network data to regulatory agencies.
• Collaborate with contracting, credentialing, and provider relations teams to address network gaps and resolve provider issues efficiently.
• Evaluate provider access, geographic distribution, and capacity to identify deficiencies and develop corrective action plans.
• Assess DSN performance metrics; identify areas for improvement and implement corrective actions.
• Ensure DSN compliance with all regulatory requirements, submitting necessary documentation and reports.
• Oversee provider network adequacy reports; ensure accuracy and compliance with regulatory standards.
• Utilize data analytics to assess provider performance, access to care, and DSN effectiveness.
• Maintain punctual, regular, and predictable attendance.
• Multitask and prioritize workload; accept direction respectfully from leadership.
• Complete all required training, including those in Relias Learning Module System (LMS).
• Perform other duties as assigned.

Qualifications

Ability to perform essential job duties with or without reasonable accommodation and without posing a direct threat to safety or health of employees or others. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.

Education

High school diploma or general education degree (GED) required.

Experience

Two to four years of related experience and/or training in healthcare provider network management, regulatory compliance, and/or data analysis required.

Technical Skills

• Familiarity with the healthcare industry.
• Exceptional writing, editing, and proofreading skills.
• Excellent organization and time‑management abilities.
• Advanced computer skills, including proficiency in Microsoft Office Suite (Outlook, Word, PowerPoint, and Excel).
• Knowledge of and compliance with HIPAA regulations.
• Knowledge of operating systems, programming languages, software programs, networks, and related technologies.
• Strong ability to identify and implement improvement activities, ensuring excellence in execution.
• Expertise in breaking projects into definable and measurable tasks, as well as tracking progress to completion.
• Knowledge of research methodologies and data analysis techniques.
• Proficiency in interpreting data to solve problems and extract new insights.
• Skill in locating and synthesizing information from various sources.
• Knowledge of customer service and service recovery best practices.
• Exceptional customer service skills, including responding appropriately and interacting positively with upset customers.
• Knowledge of project management and/or change management practices.
• Familiarity with training development and adult learning principles.
• Awareness of implicit bias, personal identity, power, and privilege in organizational and systemic contexts.
• Understanding the widespread impact of trauma and integrating trauma‑informed practices into organizational policies and procedures.

Interpersonal Skills

• Demonstrate accountability, inspiring trust and confidence from others.
• Work with high initiative, energy and effectiveness in a fast‑paced environment.
• Effectively and professionally communicate with team members and customers.
• Collaborate with a multidisciplinary, diverse team to provide professional service.
• Prioritize and organize work according to competing timelines.
• Allocate your time so you can complete tasks within established deadlines.
• Adapt to change, learn quickly, and work with ambiguity.
• Cope and self‑manage during stressful situations.
• Maintain a high degree of professionalism and confidentiality.
• Meet timelines for goals with high level of quality.
• Take initiative and apply sound judgment in completing tasks and responsibilities.

Other Requirements

• May require the use of personal vehicle for local travel (subject to mileage reimbursement).
• May require the use of a personal cell phone (cell phone stipend applicable).

Physical Demands & Work Environment

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential duties of this job. The work environment characteristics described here are representative of those an employee encounters while performing the essential duties of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties. The employee must occasionally lift and/or move up to 10 pounds. While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear. The employee is occasionally required to stand, walk, and reach with hands and arms. The noise level in the work environment is usually moderate.

• The employee must be able to work onsite, as needed.
• The employee must be able to work from a home office, as needed.
• The employee must be able to travel locally, as needed.

Employment Terms

Monday‑Friday 8:00 AM–5:00 PM with a 1 hour unpaid lunch and two 15 minute paid breaks (40 hours per week).

EEO Statement

All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sexual orientation, gender identity, sex, age, protected veteran or disabled status, or genetic information.