Provider Operations Coordinator

2 weeks ago


San Antonio TX, United States University Health Full time

POSITION SUMMARY /RESPONSIBILITIES
Responsible for the recruitment and contract management of all Provider types to ensure network is adequate and meets appropriate access/appointment availability. Interfaces with various departments to resolve provider issues related to service delivery, authorization, access/appointment availability, and specific projects and initiatives in accordance with the health plan’s policies and procedures. Facilitates and monitors provider participation in provider incentive programs, service delivery improvement activities and conducts audits to ensure compliance with regulatory and benefit program requirements. Responsible for analyzing and reporting benchmarks, deliverables and performance standards in accordance with all regulatory requirements. Serves as a subject matter expert (SME) for the core It system for the Network Management functions. Responsible for managing all relevant functions related to the core system as well as management and maintenance of the printed and electronic versions of the provider directory. Responsible for writing policies and procedures as well as revising and updating all provider manuals and other educational materials as required.

EDUCATION/EXPERIENCE
A minimum of five years of experience in customer service delivery, managed health care delivery or managed care operations environment is required (formal education may be substituted in lieu of experience). Demonstrated expertise in problem resolution skills, presentation and communication skills, data management and claims.



  • San Antonio, United States Surlean Foods Full time

    Objective: Ensure seamless plant operations through effective meeting facilitation, rigorous action tracking, and proactive team support. Focus on fostering accountability and optimizing operational performance. Core Responsibilities:Meetings & Communication:Facilitate daily management meetings, shift handovers, and leadership discussions for all shifts....


  • San Antonio, United States University Health System- San Antonio Full time

    POSITION SUMMARY/RESPONSIBILITIES Responsible for accurately maintaining provider data within the various provider subsystems and related software utilized by Community First Health Plans, Inc. (Community First). Generate all provider directories and quality check the content of the data. Requires knowledge of provider data configuration to include strong...


  • San Antonio, Texas, United States teamworkonline Full time

    At Spurs Sports & Entertainment (SS&E), we work in service of something bigger than ourselves. To us it is so much more than just a game or concert. It takes all the members of our Spurs team to harness the power of sports and entertainment to create moments that excite, memories that endure, and connections that strengthen our community. SS&E owns and...


  • San Antonio, Texas, United States MGA Homecare Full time

    Job Description This position reports directly to the Director of People Operations.  Facilitates tasks and compliance from the candidate’s acceptance to the candidate’s orientation to ensure a smooth and positive onboarding experience. Introduces candidate to the Company’s inclusive workplace culture and creates a favorable impression of the...


  • San Antonio, United States San Antonio Spurs Full time

    At Spurs Sports & Entertainment (SS&E), we work in service of something bigger than ourselves. To us it is so much more than just a game or concert.  It takes all the members of our Spurs team to harness the power of sports and entertainment to create moments that excite, memories that endure, and connections that strengthen our community. SS&E owns and...


  • San Antonio, United States CereCore Full time

    Classification: Contract Contract Length: 8-months Job ID: 16437767 CereCore provides EHR implementations, IT and application support, IT managed services, technical staffing, strategic IT consulting, and advisory services to hospitals and health systems nationwide. Our heritage is in the hallways of some of America’s top-performing hospitals. We have...

  • Safety Coordinator

    1 week ago


    San Antonio, United States Elwood Staffing Full time

    Safety Coordinator Needed for a Fullfillment Warehouse on the South West side of San Antonio. Tx Company Profile. A Fulfillment center minority-owned and operated provides technologically advanced solutions ranging from supply chain management, biote Coordinator, Safety, Order Fulfillment, Manufacturing, Staffing, Management


  • San Antonio, TX, United States Millennium Group Full time

    We are seeking a Project Coordinator for a client in San Antonio. To apply, send resume to: recruiting@millgroupusa.com Job Duties: Provides the project manager with support and assistance in scheduling meetings, and documentation Updates the project plan. Assists in information collection and validations. Helps prepare status reports and...


  • San Antonio, United States University Health System Full time

    Full Time 12238 Silicon Drive Professional Non-Nursing Day Shift POSITION SUMMARY/RESPONSIBILITIES Provider Relations Representative works as the primary liaison between Community First Health Plans and network participants (physicians, providers, and administrators) of the health plan provider network. This position will build and nurture positive...


  • San Jose, United States Momentum Resource Solutions Full time

    Job DescriptionJob Description Our client , a multinational manufacturer of computer peripherals and software, is searching for An Operations Coordinator. This is a contract role that requires employees to be onsite every Wednesday, and the rest of the week remotely. The job description is as follows: Job type: 6+ months renewable contract Location: 100%...


  • San Antonio, United States OpenText Full time

    OPENTEXT OpenText is a global leader in information management, where innovation, creativity, and collaboration are the key components of our corporate culture. As a member of our team, you will have the opportunity to partner with the most highly regarded companies in the world, tackle complex issues, and contribute to projects that shape the future of...


  • San Antonio, Texas, United States OpenText Full time

    OPENTEXT OpenText is a global leader in information management, where innovation, creativity, and collaboration are the key components of our corporate culture. As a member of our team, you will have the opportunity to partner with the most highly regarded companies in the world, tackle complex issues, and contribute to projects that shape the future of...


  • San Antonio, United States Urology San Antonio Full time

    JOB SUMMARY The Clinical Research Coordinator (CRC) will perform independently or with general direction at the fully operational journey level of the series to execute, manage, and coordinate research protocols, as directed by the Director of Research and/or Principal Investigator (PI); may coordinate the data collection and operations of several...


  • San Antonio, TX 78245, USA, United States University Health System Full time

    Full Time12238 Silicon DriveProfessional Non-NursingDay ShiftPOSITION SUMMARY/RESPONSIBILITIESProvider Relations Representative works as the primary liaison between Community First Health Plans and network participants (physicians, providers, and administrators) of the health plan provider network. This position will build and nurture positive relationships...

  • Service Coordinator

    3 weeks ago


    San Antonio, TX, United States University Hospital Full time

    Service Coordinator (RN) Full Time 12238 Silicon Drive Nursing Day Shift POSITION SUMMARY/RESPONSIBIILITIES The Service Coordinator - Registered Nurse provides STAR Kids Members with initial and ongoing assistance by identifying, selecting, obtaining, coordinating, and using Covered Services and other supports to enhance the Member's well-being,...


  • San Antonio, United States Holt Group Inc Full time

    Job Summary:This position is responsible for coordinating Facility management and services. Responsibilities will include coordination of facility maintenance and repair requests, including janitorial and various service providers. This position will also be responsible for providing a wide range of clerical/administrative, records retention, and research...

  • Service Coordinator

    3 weeks ago


    San Antonio, TX, United States University Hospital Full time

    Service Coordinator (RN) Full Time 12238 Silicon Drive Nursing Day Shift POSITION SUMMARY/RESPONSIBIILITIES The Service Coordinator - Registered Nurse provides STAR Kids Members with initial and ongoing assistance by identifying, selecting, obtaining, coordinating, and using Covered Services and other supports to enhance the Member's well-being,...


  • San Jose, United States Mota Group, Inc Full time

    Company Description We imagine what makes our customers excited and happy, and build it so they can command their world while having fun. We are known for building top-edge products that are super innovative and stylish. From world's Smallest, lightest Drone, Advanced auto-pilot GPS Drones, to Best-Seller Toys, Wireless Chargers and Wearables. Our customers...

  • Benefits Coordinator

    2 weeks ago


    San Antonio, United States Addison Group Full time

    Role Overview: As a Benefits Coordinator, you'll be responsible for managing employee benefits programs and ensuring our team members receive the support they need. You'll work closely with our HR team to administer benefits, handle inquiries, and support employee wellness initiatives. Responsibilities: Administer employee benefits programs, including...


  • San Antonio, TX, United States Urology San Antonio Full time

    Operating Room Registered Nurse The circulating nurse is responsible for monitoring the surgical procedures and assists by acting as an intermediary between the operating room staff and the rest of the surgery center. This position is responsible for providing efficient and effective patient care and achievement of desired patient outcomes. Ensuring the...