Network Coordinator
3 weeks ago
The Coordinator, Network Management is responsible for working as the internal liaison in maintaining, processing and reviewing department databases and reporting on a daily basis to assist the Network Management Department in meeting the overall network growth and development goals.
Essential Duties and Responsibilities include the following:
Assist in Network growth and development to include preparation of contract packets for recruitment projects.
Responsible to work with Network Managers and providers to obtain proper signatures and documentation to effectively process newly recruited or existing providers.
Maintaining and updating the appropriate databases and department tools with statuses.
Coordinate receipt and processing of all provider contracts, credentialing, and correspondence.
Responsible for timely and accurate completion of PACF’s related to incoming documentation received from providers regarding changes to their demographic information in the credentialing and provider network databases.
Responsible for initial review of all credentialing applications prior to submittal to RMG Contracts for completion and accuracy.
Working collaboratively with Network Managers during the contracting process to ensure department goals and requirements are being met.
Responsible for the initial submittal of provider profiles to the Health Plans and follow-up (as requested) to ensure PCP’s are active in databases.
Limited contract negotiations under the direction of the Director, Network Management and/or Vice President of Regional Operations.
Daily interaction with regional providers.
Ensure contract compliance and adherence to DMHC, DHS, CMS and other regulatory agencies as required by contracting HMOs.
Internal network liaison for Database, Claims, Customer Service, Medical Management, and Provider Relation Departments.
Perform on-site visits (as required) to physicians, physician groups, hospitals and ancillary providers.
Facilitate the scheduling of meetings with providers.
Oversight of database maintenance and accuracy through use of audits.
Ensure accurate and timely data reporting requirements are being met.
Know and follow the Employee Handbook policies and procedures.
Maintain patient confidentiality so that HIPPAA compliance is observed at all times.
All other duties as directed by management.
Distribution of work:
Daily production will vary from day to day. All assigned work must be completed by the end of business day in order to maintain turnaround time compliance.
Special Projects:
Assist with any special projects.
The pay range for this position at commencement of employment is expected to be between
$18 - $20 per hour
; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, licensure, skills, and experience.
The total compensation package for this position may also include other elements, including a sign-on bonus and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered.
Details of participation in these benefit plans will be provided if an employee receives an offer of employment.
If hired, employee will be in an “at-will position” and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.
As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare & Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success.
Full Time Position Benefits:
The success of any company depends on its employees. For us, employee satisfaction is crucial not only to the well-being of our organization, but also to the health and wellness of our members. As such, we are firmly dedicated to providing our employees the options and resources necessary for building security and maintaining a healthy balance between work and life.
Our dedication to our staff is evident in our comprehensive benefits package. We offer a very generous mixture of benefits, including many employer-paid options.
Health and Wellness:
Employer-paid comprehensive medical, pharmacy, and dental for employees
Vision insurance
Zero co-payments for employed physician office visits
Flexible Spending Account (FSA)
Employer-Paid Life Insurance
Employee Assistance Program (EAP)
Behavioral Health Services
Savings and Retirement:
401k Retirement Savings Plan
Income Protection Insurance
Other Benefits:
Vacation Time
Company celebrations
Employee Assistance Program
Employee Referral Bonus
Tuition Reimbursement
License Renewal CEU Cost Reimbursement Program
Business-casual working environment
Sick days
Paid holidays
Mileage
Requirements
Education and / or Experience:
Minimum of 2 years relevant work experience in Network Management in a managed care setting, health plan or large medical group administration.
Knowledge of contracting principles/tools.
Excellent verbal and written communication skills.
Proficient in MS Office programs (i.e., Word, Excel, Outlook, Access and Power Point)
Must be able to travel within service area and have valid driver’s license and insurance.
#J-18808-Ljbffr
-
Network Manager
4 weeks ago
Mission Viejo, California, United States Electronic Systems Inc Full timeOverview: Our client located in Mission Viejo, CA is seeking a Network Engineer for a full-time Direct Hire opportunity. In this role the Network Engineer will be responsible for designing, planning, maintaining, installing, and monitoring the district instructional and administrative wide area network (WAN). Responsibilities: • Establish...
-
Network Administrator
3 weeks ago
Los Angeles, California, United States Flynt Management Group Full timeOverview: SALARY RANGE $85,000 TO $105,000 annually (DOE) SUMMARY We are currently seeking a dynamic Network Administrator for our Retail division Benefits Medical, Dental, Vision, 401(K), vacation and sick time, paid holidays plus more! Three day weekend every other week (Altternate work week schedule) Responsibilities: ESSENTIAL DUTIES...
-
IT Network Engineer
2 weeks ago
Sacramento, California, United States CommonSpirit Health Full timeOverview: CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our...
-
Manager, Network Development
2 weeks ago
Rancho Cucamonga, California, United States Inland Empire Health Plan Full timeOverview: What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! Under the direction of the Director of Provider Network, the Network Development Manager is responsible for the successful screening...
-
Program Coordinator
2 weeks ago
California, United States Tarzana Treatment Centers Full timeCareer Opportunities with Tarzana Treatment Centers A great place to work. Share with friends! Current job opportunities are posted here as they become available. Full time Program Coordinator will be responsible for the overall day-to-day activities, management and coordination of referrals and linkage for the re-entry population. Program Coordinator will...
-
IT Coordinator
4 weeks ago
Los Angeles, California, United States PM2CM Full timeThe Technology Project Coordinator is a technical representative, charged with assisting the Technology Project Team in addressing the needs of bond funded technology projects. This position will serve as a supporting resource for Technology Project Managers in managing and maintain project documentation, scheduling meetings, and serving in an overall...
-
Access Network Engineering Leader
7 days ago
Carlsbad, California, United States Viasat, Inc. Full timeAbout us: One team. Global challenges. Infinite opportunities. At Viasat, we’re on a mission to deliver connections with the capacity to change the world. For more than 35 years, Viasat has helped shape how consumers, businesses, governments and militaries around the globe communicate. We’re looking for people who think big, act fearlessly, and create an...
-
RN Care Coordinator
3 weeks ago
Woodland, California, United States CommonSpirit Health Full timeOverview: Dignity Health Woodland Memorial Hospital is Yolo County’s largest health care provider serving the community since 1905. Woodland Memorial Hospital is a 108-bed acute care facility offering the most comprehensive range of health care services in Yolo County including inpatient and outpatient surgical services family birth center/labor and...
-
RN Care Coordinator
3 weeks ago
Oxnard, California, United States CommonSpirit Health Full timeOverview: St. John’s Regional Medical Center located in Oxnard California is a recognized as a Top 250 Hospital in the Nation and as one of America’s 100 Best Hospitals for Cardiac Care by Healthgrades. St. John’s Regional is a part of Dignity Health’s Southern California Division and is a member of CommonSpirit Health the largest not-for-profit...
-
HR Coordinator
2 weeks ago
Redding, California, United States CommonSpirit Health Full timeOverview: For more than 70 years Mercy Medical Center Redding has offered comprehensive health care in the North State providing acute care and a full range of medical services. The 267-bed hospital offers major medical services including a Level II Trauma Center as well as specialized Cardiovascular Care Stroke Care Orthopedics Neurological Surgery...
-
Care Coordinator
4 weeks ago
Fairfield, California, United States Seneca Family of Agencies Full timeOverview: Do you have four years of experience working with youth and families in a mental health setting? Join our Wraparound Team as a Care Coordinator! As the Care Coordinator on the team, you will be responsible for meeting with clients and caregivers on a weekly basis, provide psychoeducation, and further treatment goals by coordinating care...
-
Community Health Education Coordinator
4 weeks ago
Stockton, California, United States CommonSpirit Health Full timeOverview: St. Josephs Medical Center is a member of Dignity Health. The word dignity perfectly defines what our organization stands for showing respect for all people by providing excellent care. St. Josephs Medical Center was founded in 1899 under the direction of the Dominican Sisters of San Rafael is a not for profit fully accredited regional hospital...
-
Marketing Coordinator Costa Mesa, California
2 weeks ago
California, United States EARC, INC. Full timeARC Document Solutions, Inc. (NYSE: ARC) provides technology and services to businesses of all types, with a focus on the architectural, engineering, and construction industry, in thousands of customer locations nationwide, 170 worldwide service centers, and secure document storage in the cloud. Find out more at www.e-arc.com . Who we’re looking...
-
Registered Dietitian
4 weeks ago
Fairfield, California, United States Elite Staffing Network LLC Full timeElite Staffing Network is seeking a Registered Dietitian for a full-time position at David Grant Medical Center, Travis AFB, CA. * Excellent Compensation & Exceptional Comprehensive Benefits! * Paid Vacation, Paid Sick Time, Plus 12 Paid Federal Holidays! * Medical/Dental/Vision, Health Savings Account available, STD, LTD and Life Insurance! and...
-
Program Coordinator
4 days ago
California, United States accesso Technology Group Full timePosition Overview : Do you love working in a fast-paced environment, meeting new people and are excited about the attractions industry? As a Program Coordinator, you are responsible for assisting THE FLASH Pass Program Manager and partnering with the client in overseeing THE FLASH Pass Program and the day-to-day operations. This role will ensure a seamless...
-
Telecommunications Engineer
7 days ago
California, United States ActioNet Full timeTelecommunications Engineer - Voice, Video, Data | Req#3443 ActioNet has an immediate opportunity for a Telecommunications Engineer - Voice, Video, Data requiring a Secret clearance located in San Diego, CA. ActioNet is an IT service provider and solutions integrator headquartered in Vienna, VA that works with the Federal Government and Department of...
-
Activities & Volunteer Coordinator
4 weeks ago
Westlake Village, California, United States Sunrise Senior Living Full time: Sunrise Senior Living was again certified as a Great Place to Work® by Activated Insights. This is the 6th time Sunrise has received this top culture and workplace designation, highlighting the special place Sunrise is to be a part of. COMMUNITY NAME: Sunrise of Westlake Village Job ID: (phone number removed) JOB OVERVIEW: "Sunrise is the best place...
-
Pharmacy Technician Floater
4 weeks ago
Beverly Hills, California, 90213, Los Angeles County, CA, United States CEDARS-SINAI Full timeJob DescriptionWhen the work you do every single day has a crucial impact on the lives of others, every effort, every detail, and every second matters. This shared culture of passion and dedication pulses through Cedars-Sinai, and it’s just one of the many reasons we’ve achieved our six-consecutive Magnet designation for nursing excellence. From working...
-
IT Engineer
4 weeks ago
California, United States CareerBuilder Full timeFreshworks makes it fast and easy for businesses to delight their customers and employees. We do this by taking a fresh approach to building and delivering software that is affordable, quick to implement, and designed for the end user. More than 50,000 companies -- from startups to public companies -- around the world use Freshworks software-as-a-service to...
-
Software Engineer
3 weeks ago
California, United States Avispa Technology Full timeSoftware Engineer 13471 A leading professional networking company is seeking a Software Engineer . The successful candidate will develop and operate mission-critical services and applications that are used customers and employees worldwide. The ideal candidate has 4+ years of software engineering experience. The company offers a great work...