Network Ops Coordinator II

HCSC Group; National (NV); Hybrid; USD 48,000 - 86,000; Full time

Job summary

CareAllies seeks a role focusing on performance measures, annual wellness, provider relations, and network operations. Responsibilities include ownership of specialized provider support duties and collaboration with internal/external stakeholders to improve data integrity and performance.

The role requires a bachelor’s degree or 4 years in health care, 2 years in network contracting/credentialing, strong communication, analytical skills, and independence.

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.

Responsibilities

• Oversee areas: HEDIS/Quality measures, Medicare Wellness Visit/Attestation, provider relations, operations and systems.
• Manage data integrity and provider performance engagement.
• Lead specialized provider support duties with independent initiative.
• Participate in internal provider meetings and cross-functional work groups.

Skills

Provider network contracting

Credentialing systems

Written and verbal communication

Analytical skills

Independent initiative

Population Health Management apps

Microsoft Office (Excel, PowerPoint)

Education

Bachelor's degree

4 years experience in Health Care industry

Tools

Excel

PowerPoint

Job description

Job Summary

This Position Is Responsible for the following areas: 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 Is An Important Part Of This Role. Responsibilities Include 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. This Role Includes 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.

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

Flex employees are expected to be in the office a minimum of three days a week. Management will have discretion to modify an employee’s weekly schedule for exigent circumstances.

EEO 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. We are a drug-free and smoke-free workplace. Employment may be contingent upon successful completion of drug screening in accordance with applicable law.

Pay Transparency Statement:

At CareAllies, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, a minimum of 15 days’ of paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for full-time employees.

The salary offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

Min to Max Range:

$47,500.00 - $86,000.00

Exact compensation may vary based on skills, experience, and location.