Provider Network Coordinator

Arizona Priority Care; Chandler (AZ); On-site; USD 33,000 - 36,000; Full time

Job summary

Arizona Priority Care (AZPC) is an Integrated Provider Network focused on whole-person care for Senior and Medicaid populations in Arizona, based in Chandler. The Network Management Coordinator provides support to internal departments, contract managers and senior management, building strong provider relationships and resolving issues promptly.

The role includes maintaining provider directories, communicating network changes to health plans and CMS, processing new contracts and updates, and

Qualifications

• Associates degree or relevant equivalent experience.
• Experience with Physician Network Contracting and Provider Relations.
• Proficient with MS Office and office equipment.
• Ability to maintain confidentiality and multi-task in a high-stress environment.
• Excellent written and verbal communication skills.
• Professional interaction with providers and positive representation of the company.

Responsibilities

• Serve as first contact for provider inquiries (contract status, claims, demographics, complaints).
• Manage provider rosters and communications of updates.
• Maintain reference materials and Health Plan protocols.
• Support provider contract processing and credentialing workflow.
• Process new contracts across lines of business.
• Handle provider updates (adds, terminations, demographics) for all lines.
• Assist with contract amendments as needed.
• Contribute to process improvement and best practices.
• Help develop standard department procedures.
• Collaborate on special projects and data reviews.
• Other duties as assigned.

Skills

Provider relations

Customer service

Contracting

Communication

Education

Associates degree or relevant equivalent

Tools

MS Office

Job description

Job Overview

Arizona Priority Care (AZPC) is an Integrated Provider Network focused on providing whole-person care to Senior and Medicaid populations, through advanced value-based models. Our provider network is comprised of more than 6,000 health care providers, including primary and specialty care physicians, hospitals and ancillary providers. We have operated in the Arizona market for more than 14 years, based in Chandler, Arizona, and are an affiliate of Heritage Provider Network. As a leading value-based provider organization, we are committed to improving the quality of care, providing excellent member and provider experiences all while reducing cost.

Job Overview

Arizona Priority Care (AZPC) is an Integrated Provider Network focused on providing whole-person care to Senior and Medicaid populations, through advanced value-based models. Our provider network is comprised of more than 6,000 health care providers, including primary and specialty care physicians, hospitals and ancillary providers. We have operated in the Arizona market for more than 14 years, based in Chandler, Arizona, and are an affiliate of Heritage Provider Network. As a leading value-based provider organization, we are committed to improving the quality of care, providing excellent member and provider experiences all while reducing cost. The Network Management Coordinator provides assistance to internal departments, Contract Managers and Senior Management. The coordinator builds and maintains working relationships with AZPC providers and researches and resolves provider issues. Ensure network directories are maintained and current in all applicable databases and internal tracking systems. Notifications of network changes are communicated timely to internal departments as well as Health Plans and CMS REACH ACO Model, which includes but is not limited to: internal and external provider communications related to provider additions, provider terms, new contracts and demographics changes. Maintains a professional, positive and caring attitude at all times.

POSITION DUTIES & RESPONSIBILITES

• Demonstrates an in-depth knowledge of provider networks and providers’ needs; demonstrates ability to build strong, positive provider relationships; serves as expert consultant and resource to team members in identifying and resolving provider issues by demonstrating a high level of customer service.
• Manages and promotes provider satisfaction through ensuring practice service, support and education.
• Assists and ensures that appropriate reference materials and Health Plan protocols are current and consistent.
• First point of contact for provider inquiries, including provider contract status, claim issues, demographic updates, complaints or concerns.
• Assists in Provider Network communication of critical information to providers, plan updates through email/fax blasts, and other communications.
• Review and maintenance of provider rosters.
• Participates in special projects, which may include completion of contract term sheets, contract configuration on new and/or existing contracts and contract data reviews.
• Receives and processes new contracts, for all lines of business to ensure all required documents are complete. Submits required documents to credentialing, systems loading and tracks through the continuum to ensure accurate completion implementation both internally and with Health Plans.
• Processes all provider updates for existing contracts including but not limited to; provider adds, provider/group terminations and demographic updates for all lines of business.
• Assists in provider contract amendments as required.
• Actively identifies opportunities for process improvement and communications best practices to improve overall efficiency.
• Assists in the identification and development of standard department procedures.
• Other duties as assigned.

Education, Training And Experience

• Associates degree or relevant equivalent experience.
• Prior experience with Physician Network Contracting and Provider Relations
• Proficient in office equipment (computers, printers, etc.) and MS Office programs.
• Ability to maintain confidentiality; and ability to multi-task n a high stress environment/
• Excellent written and verbal communication skills.
• Must be able to interact with providers in a professional manner with a strong commitment to positively representing the company.
• This role requires 60 days FT in office presence, hybrid options will be available after the 60-day period.*

Compensation Range: $24-$26