Network Ops Coordinator II

CareAllies Inc.; Houston (TX); Hybrid; USD 42,000 - 93,000; Full time

Benefits offered by this job

Health and wellness benefits

401(k) savings plan

Pension plan

Paid time off

Paid parental leave

Disability insurance

Supplemental life insurance

Employee assistance program

Paid holidays

Tuition reimbursement

Plus other incentives

Job summary

HCSC is seeking a field-oriented professional to oversee provider network operations, quality measures, and data integrity across a broad health care network. You will engage with providers, manage contracts and credentialing, and collaborate with internal teams to improve performance metrics.

The role requires a bachelor degree or equivalent health care experience, strong analysis, and effective communication.

Qualifications

• Bachelor degree OR 4 years of experience in the health care industry.
• 2 years of experience with Provider Network contracting and credentialing systems.
• Strong written and verbal communication skills with internal and external customers.
• Analytical and quantitative skills.
• Ability to take initiative and work independently.

Responsibilities

• Overall Performance/HEDIS Quality Measures.
• Medicare Annual Wellness Visit/Attestation Completion.
• Provider Relationship Management.
• Operations and Systems (Pop Health Platform, Salesforce updates, cross-functional collaboration with internal and external stakeholders) and maintenance of professional provider data to support key value-based care initiatives, membership and network operations.
• Building relations with the provider community.
• Promoting high-quality initiatives to support data integrity.
• Owning and leading highly specialized operational and provider support duties requiring independent initiative and problem-solving.
• Participating in internal provider meetings and work groups.
• Researching problems related to provider performance/engagement, data and network participation.

Skills

Written communication

Verbal communication

Analytical thinking

Initiative

Education

Bachelor degree or equivalent experience

Tools

Population Health Management

Microsoft Excel

PowerPoint

Job description

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job Summary

This Position Is Responsible for the following areas:

Responsibilities

• Overall Performance/HEDIS Quality Measures
• Medicare Annual Wellness Visit/Attestation Completion
• Provider Relationship Management
• Operations and Systems (Pop Health Platform, Sales Force Updates, Cross-Functional Collaboration (Internal and External Stakeholders) and Maintenance Of Professional Provider Data To Support Key Value-Based Care Initiatives, Membership And Network Operations)
• Building Relations With The Provider Community
• Promoting High-Quality Initiatives To Support Data Integrity
• Accepting Ownership And Leading Highly Specialized Operational And Provider Support Duties That Require Independent Initiative and Problem-Solving
• Participating In Internal Provider Meetings And Work Groups
• Researching Problems Related To Provider Performance/Engagement, Data And Network Participation

Required Job Qualifications

• Bachelor degree OR 4 years of experience in the Health Care industry
• 2 years of experience with Provider Network contracting and credentialing systems
• Written and verbal communication skills to interact with internal and external customers
• Analytical and quantitative skills
• Ability to take initiative and work independently

Preferred Job Qualifications

• Subject Matter Expert in Professional Provider Network Relations (claims service issues, contracting, and finance)
• Experience with Population Health Management applications and Microsoft Office Tools including Excel (VLOOKUPS, pivot tables) and Power Point

Hybrid Role based out of Philadelphia, PA - 80% of your time will be spent out in the field meeting with Providers.

Benefits

• health and wellness benefits
• 401(k) savings plan
• pension plan
• paid time off
• paid parental leave
• disability insurance
• supplemental life insurance
• employee assistance program
• paid holidays
• tuition reimbursement
• plus other incentives

Base Pay Range $41,700.00 - $92,800.00 Exact compensation may vary based on skills, experience, and location.

This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

HCSC Employment Statement: We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

HCSC is an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace.

HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants.

If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations. Please note that only requests for accommodations in the application process will be returned.