Coord Provider Network - Remote, Ohio Region

Location: Dublin, OH

Primary Job Function: Medical Management

ID**: 34161

Your career starts now. We are looking for the next generation of health care leaders.

At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we would like to connect with you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

Responsibilities:

The Coordinator, Provider Network Operations supports the Provider Network Operations team in managing Plan operational functions and activities; key responsibilities include:

• Coordinates and facilitates administrative activities including meetings and material development (P&Ps, desk procedures, workflows, etc.).

• Performs provider AGID assignment/submissions to EO.

• Performs provider roster analysis/management (adds, changes, terms) and subsequent submissions to EO for update.

• Coordinates and submits panel transfers.

• Performs other related duties and projects as assigned.

Education/Experience:

• Associate’s Degree preferred or equivalent combination of education and work experience in a Health Care field.

• 1 to 3 years relative experience in previous claims, provider data, healthcare, managed care or insurance industry environment preferred.

• Must be proficient in Microsoft Office products.

• Superior organizational skills preferred.

• Critical thinking skills.

• Billing and coding experience/knowledge a preferred.

• Strong customer service skills.

• Excellent written and verbal communication.

• Track record of Customer Excellence.

• Demonstrated ability to coordinate activities across functional areas.

• Sound personal management skills to plan, organize, schedule, and complete own work and work that is coordinated with others.

Diversity, Equity, and Inclusion

At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

We keep our associates happy so they can focus on keeping our members healthy.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

EOE Minorities/Females/Protected Veterans/Disabled