Network Coordinators, WellMed - El Paso

Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm)

The Network Coordinator is responsible for developing, maintaining and servicing a high quality, marketable and satisfied provider network within an assigned geographic area for WellMed.  Key responsibilities include support and education for contracted physicians and ancillary providers.  The Network Coordinator helps assigned primary care physicians operate successfully within the healthcare delivery model in support of enterprise goals.  This position works closely with local marketing and medical staff, as well as corporate support functions.  This position is expected to maintain strong working relationships with assigned physicians, hospitals and ancillary providers.

Under the direction of the Manager, Physician Business Support, the Network Coordinator works closely with contracted PCPs to ensure they have the tools they need to meet Quality Metric goals including DataRaps and FOC; completes detailed analysis of Quality Metric reports and tracks data at the patient level to ensure new members are seen within 90 days, all members seen annually and completion of the actions needed to meet the remaining quality metrics, and provides physician and office education to improve metrics as needed.

The Network Coordinator participates in creation and execution of a local network development plan to assure network adequacy, meets regularly with contracted providers and staff to review metrics and ensure appropriate tools and resources are available and utilized, and conducts new provider orientations and deliver in-service training to educate providers and their staffs on PHC products, processes and compensation arrangements; he/she also maintains open communication with providers on health plan issues related to claims, eligibility, RAPS, disease management, utilization management, reimbursement and quality programs, collaborates with market leadership to monitor utilization trends and profit pools and share results with assigned PCPs, and resolves provider and member specific issues related to claims, eligibility and referrals.

Also, the Network Coordinator handles scheduling, agenda, materials, location, meals and minutes of provider meetings as needed, works closely with contracting team to ensure provider data is correct and Provider directories include any needed updates, completes appropriate forms as needed, and provides information and participates in management meetings as requested, as well as all other related duties as assigned.

Bi-lingual candidates strongly preferred

Frequent on-site visits and meetings with physician groups or hospital systems- must be able to travel

Requirements:

- Solid knowledge of local provider community

- Intermediate level of proficiency with MS Word, Excel, PowerPoint and Access.

 
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.SM

Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.