Network Operations Coordinator - Remote

Overview

The Network Operations Coordinator plays a crucial role in maintaining provider relations and managing data integrity for health plans, ensuring seamless service operations.

In Short

• Manage provider relations to support customer service activities.
• Handle provider data management for health plans.
• Execute processes for managing provider service failures.
• Ensure data integrity in contracts and operations.
• Act as the point of contact for contract administration.
• Utilize APEX, CAS, and PMDM systems effectively.
• Collaborate with Provider Engagement professionals.
• Manage operational issues related to data integrity.
• Assist with routine provider contracts as needed.
• Work from home with necessary internet requirements.

Requirements

• High School Diploma or equivalent.
• 2+ years of provider relations experience.
• Intermediate skills in Microsoft Word and Excel.
• Experience in provider contract interpretation.
• Associate’s or Bachelor’s Degree preferred.
• Knowledge of medical claims is a plus.
• Able to handle multiple projects simultaneously.

Benefits

• Competitive medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off and holidays.
• Short-term and long-term disability insurance.
• Life insurance and other opportunities.