Provider Network and Operations Coordinator - Hybrid

MercyOne Medical Group; Clive (IA); Híbrido; USD 55.000 - 70.000; Jornada completa

Descripción de la vacante

MercyOne Medical Group in the United States is seeking an Operations Coordinator to support MercyOne PHSO’s Provider Network and Compliance teams. The hybrid role includes managing the Provider Network Directory, participating in recruitment coordination, and assisting with contract­ing and inquiries.

Responsibilities include supporting policy handbooks, conducting user audits, coordinating meetings, and tracking deliverables.

Formación

• Bachelor’s degree preferred; in lieu of education, work history may be considered.
• Minimum one year in a healthcare system, health plan, or accrediting body.
• Experience with ACOs and value-based care is preferred.
• Proficient in Microsoft Office applications (Word, Excel, PowerPoint).
• Strong verbal communication and critical thinking skills.
• Excellent writing, organization, and multi-tasking abilities.
• Project management skills highly preferred.
• Strong presentation skills are a plus.
• Ability to collaborate in a shared leadership environment.
• Demonstrates honesty, integrity, and caring aligned with mission.

Responsabilidades

• Knows and demonstrates Trinity Health Mission, Vision, and Values.
• Provider Network Support: implement and maintain NCQA-compliant directory; develop intake forms; coordinate recruitment; assist in contracts; respond to inquiries.
• Compliance Support: manage policy handbook; conduct documentation audits; assist in regulatory inquiries; onboard new participants/providers; handle inquiries.
• Project & Meeting Support: create agendas, prepare materials, take minutes; track deliverables; coordinate changes in processes; maintain education content.
• Other duties as assigned by the manager; maintain knowledge of applicable laws and integrity program.
• Support in a collaborative environment and uphold ethical standards.

Conocimientos

Microsoft Office

Project coordination

Verbal communication

Interpersonal skills

Educación

Bachelor’s degree preferred

Herramientas

SharePoint

CRM software

Descripción del empleo

Employment Type:Full timeShift:Day ShiftDescription:WHO WE ARE

MercyOne Population Health Services Organization (PHSO) is a clinically integrated network comprised of independent, owned, and managed affiliates. The Provider Network team is responsible for building and maintaining a robust network of high-quality partnered providers. We manage provider relationships, contracting, and the preferred payer agreements.Additionally, we serve as a critical link between our providers and preferred payers, advocating on behalf of the network by escalating concerns, including claims-related issues, and following them through to effective resolution.

POSITION PURPOSE

This hybrid role works in office twice a week once trained and is an integral team member of MercyOne PHSO’s Operations team, the Provider Network and Operations Coordinator assists PHSO leadership on tasks as assigned. Functions including oversight and management for the MercyOne Provider Network Directory, Compliance & auditing, and coordination of projects. Serves as a liaison between PHSO administration, Chapters, regulatory bodies, and MercyOne Partnered Provider organizations/providers as needed. This role is part of the MercyOne PHSO Operations team, reporting to the Provider Network Supervisor.

ESSENTIAL FUNCTIONS

1. Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions.

2. Provider NetworkSupport

• Serves as the key resource to implement andmaintainan accurate, NCQA-compliant Provider Network Directory.
• Develops andmaintainsintake/assessment forms to gather key information to support the Provider Network Directory.
• Coordinates with Medical Staff Offices, Physician Recruitment and Employment, and Clinic Managers to obtain all required informationas part of recruitment processes.
• Assistsin the management of PHSO Participant Agreements and Network Contracting.
• Assistsin the investigation and response to member inquiries related to the Provider Network and Directory.

3. Compliance Support

• Manages andmonitorselectronic Policy and Procedurehandbook.
• Completes documentationand useraudits according to federal and state health statutes, as well as third party control provisions.
• Assists the ACO ComplianceOfficialin evaluating and responding to inquiries from governing bodies/regulatory agencies (i.e.: CHAN, Centers forMedicareand Medicaid Services)
• Assistsin theon-boardingof new ACO Participantsand Providers.
• Responds to PHSO email and phone inquiries from patients,providersand regulatory bodies.

4. Project& MeetingSupport

• Assistswith agenda creation, presentation of materials, and minutes for key meetings, including Provider Network Counciland Chapter Governance Meetings.
• AssistsPHSO leadershipwith special projects, including the tracking of deliverables, compiling information and reports, etc.
• Acts asresourcein various committees and meetings to coordinate changes in ACO processes.
• Maintains PHSO directories, websites, andSharepointsites with education content.

5. Other duties as needed and assigned by the manager.

6. Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.

MINIMUM QUALIFICATIONS

1.Bachelor’s degree preferred. In lieu of educationalrequirements,previouswork history and years of experience may be considered.

2. Minimum ofone year of experience with a healthcare system, healthplanor healthcare accrediting body. Prior experience inproject coordinationpreferred.

3. Experience in ACOs and knowledge of value-based care is preferred.

4. Demonstrated proficiency in Microsoft applications (e.g., Word, Excel, PowerPoint) required.

5. Strong demonstrated verbal communication and critical thinking skills required.

6. Excellent verbal and writing skills required.

7. Excellent organizational skills and attention to detail required.

8. Ability to manage and prioritize multiple deliverables required.

9. Excellent project management skills strongly preferred.

10. Demonstrated presentation skills preferred.

11. Must be comfortable operating in a collaborative, shared leadership environment.

12. Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Trinity Health and MercyOne.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.