Network Operations Coordinator II - Provider Performance - Houston, TX

Health Care Service CorporationHouston, TX
2dHybrid

About The Position

At CareAllies, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Job Summary As a part of the Provider Engagement Team, this position will work closely with providers to accelerate their transition to value-based care and to help them manage the long-term health of their patients. This position uses a consultative approach, emphasizing physician engagement, delivery system organization and culture change, actionable data and analytics, as well as patient engagement to support treatment plans. We collaborate with providers to drive change and ensure success in a value-based market. This position is also responsible for the contracting, credentialing, and maintenance of professional provider data to support marketing, membership and network contracting across all lines of business. 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 customer support duties that require independent initiative. This role includes participating in internal provider meetings and work groups, researching problems related to provider credentialing, data and network participation.

Requirements

  • 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

Nice To Haves

  • Subject Matter Expert for the Professional Provider Credentialing Process
  • Experience with Microsoft Office applications including Excel, Access, and Power Point
  • Previous HEDIS and/or CMS STARs experience
  • Solid understanding of health insurance, customer messaging/design and project management
  • Strong experience using Microsoft products, including Excel (knowledge of pivot tables, VLOOKUP, etc.) and PowerPoint
  • Experience in financial/trend analysis
  • Team player with proven ability to foster and manage working relationships within a matrix environment to obtain buy-in and drive results

Responsibilities

  • promoting high quality initiatives to support data integrity
  • Accepting ownership and leading highly specialized operational and customer support duties that require independent initiative
  • participating in internal provider meetings and work groups
  • researching problems related to provider credentialing, data and network participation

Benefits

  • 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
  • other incentives
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