NETWORK COORDINATOR

    Charleston Area Medical Center
    Charleston, WV, CHARLESTON, WV
    Full-time

    Job Description

    Summary
    • Basic Description
    • Under the direction of the Operations Manager, the Network Coordinator will support the clinically integrated provider networks. He/she is responsible for working with Manager to ensure maintenance of the provider networks, including, but not limited to: agreement maintenance, provider database maintenance, liaison with internal teams of the health system, liaison with providers and office staff for issue resolution, liaison with payers and internal personnel for issue resolution. Due to the need to continuously educate our partners and monitor progress on metrics, experience with healthcare data analysis is a plus.
      • Essential Duties and Responsibilities
        • Assists with management and tracking of all population health provider agreements and required documentation.
        • The Network Development Coordinator will function as a mid-level analyst and assist in the day- to- day activities of managed care contracting and payer analytics.
        • Assists with being a resource, answering questions and providing information about contracts and reimbursement. Reviews billings and claims payments according to managed care contracts.
        • Supports Vice President of Managed Care/President of the Health Network in contract negotiations and rate modeling efforts.
        • Candidates should have experience with creating formulas and charts in Excel, an enthusiastic attitude towards learning and demonstrated attention to detail.
        • Communicates with internal and external teams for accurate network payer rosters
        • Supports value-based contract requirements (Medicare Shared Savings Program and other payers). -includes ACO activities, CMS submissions, value-based payer support, and bundles
        • Assists with meeting scheduling
        • Troubleshoots problems and issues regularly on behalf of the team, and works proactively to prevent them
        • Monitors the publicly available information related to competitor's network development in population health programs
        • Performs other duties as assigned and needed by the network
        • Assists with formulating and presenting reports and organizes implementation activities.
        • Provides project management and basic analytics support to the Health Network team.
        • Provides and promotes excellent customer service for both internal and external customers. Holds self and others accountable for behaviors that promote service excellence.
        • Must be results-oriented with the ability to prioritize and manage multiple projects simultaneously.
        • Comfortable working in a fast-paced, dynamic environment while maintaining focus on key goals.
        • Familiarity with value-based care concepts including the triple aim, risk stratification, and accountable care.
      • Specialized Knowledge, Experience and Skills
        (Education, Experience and Skills required to fully perform the requirements of the position)
      • Degree / Education
        • Bachelor Degree - business- accounting- finance or related field
      • Level of Experience
        • Three to five years' experience with healthcare delivery systems; physician practices; payers or combination.

          Knowledge of Managed Care contracting and payor reimbursement methodologies.
      • Lic./Cert./Reg.
        • All licensure must be current/valid and from the state of West Virginia.
        • Drivers License
      • Typing/Word Processing skills required for this position
        • Type of software - Related types for spreadsheets and wordprocessing
        • Basic pc skills
      • Computer Skills required for this position
      • Other Required Areas of Knowledge, Skills and Abilities
        • Analytical Skills
        • Applies knowledge to new situations
        • Bookkeeping
        • Customer Service
        • Decision Making
        • Employee Relations
        • Handle Multiple Assignments
        • Judgment
        • Keyboarding
        • Math Complex
        • Math Simple
        • Problem Solving
        • Project Management
        • Public Speaking
        • Teamwork
        • Verbal Communication
        • Work Independently
        • Written Communication
      • Acceptable SUBSTITUTIONS (if any)
      • Assigns work to or supervises others
      • Competency Statement
        • Must demonstrate competency through an initial orientation and ongoing competency validation to independently perform tasks and additional duties as specified in the job description and the unit/department specific competency checklist.
    Posting ID: 552623479Posted: 2020-03-11