PNO Contract Coordinator
3 weeks ago
Job Description Job Description SummaryUnder the general direction of the Provider Network Operations (PNO) Contracting Supervisor, the PNO Contract Coordinator is responsible for the managing and supporting the administrative and operational aspects of the PNO Contracting Team. This includes but is not limited to pre and post negotiation management, interfacing with PNO, Claims, Utilization Management (UM) and other departments. The PNO Contract Coordinator performs basic administrative, clerical, operational, customer support and computational tasks to support the PNO Contract Specialist(s) in the network development component of MedPOINT Managements (MPM) service portfolio.Duties and Responsibilities Ensure completeness and conduct follow-ups for receipt of provider applications and supporting documents following providers/vendors contract execution Ensure completeness of health plan required attestations among Clients provider network Log provider follow-up outcomes and status updates in Letter of Agreement (LOA) Utility; submit to the database to be loaded once signed copy is returned Perform continued follow-up on all LOAs, both Patient-Specific and Blanket Complete MPM Contract Routing Checklist upon return to ensure accuracy and completeness of required documents and submit to respective Provider Network Operations database team Assist Contract Specialists and Contracts Supervisor in responding to Health Plan, IPA, DMHC, DHCS, CMS or regulatory body audit requests Respond to and close out MPM departmental requests (Claims, Rates, UM etc.) for copies of contracts or amendments Escalate contract inquiries to Contract Specialist if entity/provider requests rate re-negotiation or amendment; log and track all rate re-negotiation requests Upload contracts, amendments, Blanket/Patient-Specific LOAs into respective database/storage repository (EZ-CAP Document Management, Laserfiche, Shared Network Folders, LOA Utility) Participate in weekly B-Report meetings to report on pre-arrivals, communications between hospital LOAs, and pertinent updates Assist in research of provider-related issues including demographic information, contracting status, credentialing status, claim issues and status in MPM database Assist in constant analysis of contracting needs, maintaining spreadsheets and collect, track, prepare, compile, and distribute statistical data for daily and monthly reports Respond to email correspondence and other communication in a professional and timely manner Ensure HIPAA compliance is always observed/performed Understand and follow the MPM Employee Handbook policies and procedures Perform additional duties/assignments as neededMinimum Job Requirements Bachelors degree in healthcare, human services or related field preferred 2+ years Managed Care or Healthcare experience in Network Management or Contracting Knowledge of contracting principles and tools, experience in legal/paralegal process a plus EZ-CAP knowledge preferred Proficient in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook) Substantive knowledge of the HMO marketplace including Medi-Cal, Commercial, and Medicare#J-18808-Ljbffr
by Jobble
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PNO Contract Coordinator
2 months ago
Los Angeles, United States MedPOINT Management Full timeJob DescriptionJob DescriptionSummaryUnder the general direction of the Provider Network Operations (PNO) – Contracting Supervisor, the PNO Contract Coordinator is responsible for the managing and supporting the administrative and operational aspects of the PNO Contracting Team. This includes but is not limited to pre and post negotiation management,...
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PNO Contract Coordinator
3 weeks ago
Los Angeles, United States MedPOINT Management Full timeJob DescriptionJob DescriptionSummaryUnder the general direction of the Provider Network Operations (PNO) – Contracting Supervisor, the PNO Contract Coordinator is responsible for the managing and supporting the administrative and operational aspects of the PNO Contracting Team. This includes but is not limited to pre and post negotiation management,...
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PNO Contract Coordinator
1 week ago
Los Angeles, California, United States MedPOINT Management Full timeJob Description Job Description SummaryUnder the general direction of the Provider Network Operations (PNO) – Contracting Supervisor, the PNO Contract Coordinator is responsible for the managing and supporting the administrative and operational aspects of the PNO Contracting Team. This includes but is not limited to pre and post negotiation management,...
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PNO Compliance Coordinator
1 month ago
Los Angeles, United States MedPOINT Management Full timeJob Description Job Description Summary Under the general direction of the Provider Network Operations (PNO) Delegation Specialist, the Compliance Coordinator supports the day-to-day audit and monitoring processes to ensure the department delivers high-quality reviews and results. They will assist with coordinating large department projects or lead special...
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PNO Compliance Coordinator
2 months ago
Los Angeles, United States MedPOINT Management Full timeJob DescriptionJob DescriptionSummaryUnder the general direction of the Provider Network Operations (PNO) Delegation Specialist, the Compliance Coordinator supports the day-to-day audit and monitoring processes to ensure the department delivers high-quality reviews and results. They will assist with coordinating large department projects or lead special...
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PNO Compliance Coordinator
2 months ago
Los Angeles, United States MedPOINT Management Full timeJob DescriptionJob DescriptionSummaryUnder the general direction of the Provider Network Operations (PNO) Delegation Specialist, the Compliance Coordinator supports the day-to-day audit and monitoring processes to ensure the department delivers high-quality reviews and results. They will assist with coordinating large department projects or lead special...
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PNO Compliance Coordinator
3 weeks ago
Los Angeles, United States MedPOINT Management Full timeJob DescriptionJob DescriptionSummaryUnder the general direction of the Provider Network Operations (PNO) Delegation Specialist, the Compliance Coordinator supports the day-to-day audit and monitoring processes to ensure the department delivers high-quality reviews and results. They will assist with coordinating large department projects or lead special...
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PNO Compliance Coordinator
5 days ago
Los Angeles, United States MedPOINT Management Full timeJob Description Job Description Summary Under the general direction of the Provider Network Operations (PNO) Delegation Specialist, the Compliance Coordinator supports the day-to-day audit and monitoring processes to ensure the department delivers high-quality reviews and results. They will assist with coordinating large department projects or lead special...
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PNO Compliance Coordinator
3 weeks ago
Los Angeles, United States MedPOINT Management Full timeJob DescriptionJob DescriptionSummaryUnder the general direction of the Provider Network Operations (PNO) Delegation Specialist, the Compliance Coordinator supports the day-to-day audit and monitoring processes to ensure the department delivers high-quality reviews and results. They will assist with coordinating large department projects or lead special...
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Provider Network Operations
2 months ago
Los Angeles, United States MedPOINT Management Full timeJob DescriptionJob Description SummaryUnder the Provider Network Operations (PNO) Database Management Supervisor's general direction, the PNO Database Management Support I is responsible for ensuring accurate, timely, and efficient provider profile creation in all Client IPA databases. This position's primary function is to create provider profiles...
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Provider Network Operations
3 weeks ago
Los Angeles, United States MedPOINT Management Full timeJob DescriptionJob Description SummaryUnder the Provider Network Operations (PNO) Database Management Supervisor's general direction, the PNO Database Management Support I is responsible for ensuring accurate, timely, and efficient provider profile creation in all Client IPA databases. This position's primary function is to create provider profiles...
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Los Angeles, United States MedPOINT Management Full timeJob DescriptionJob Description SummaryUnder the Provider Network Operations (PNO) Database Management Supervisor's general direction, the PNO Database Management Support I is responsible for ensuring accurate, timely, and efficient provider profile creation in all Client IPA databases. This position's primary function is to create provider profiles...
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Los Angeles, United States MedPOINT Management Full timeJob DescriptionJob Description SummaryUnder the Provider Network Operations (PNO) Database Management Supervisor's general direction, the PNO Database Management Support I is responsible for ensuring accurate, timely, and efficient provider profile creation in all Client IPA databases. This position's primary function is to create provider profiles...
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Outpatient UM Coordinator
4 weeks ago
Los Angeles, United States MedPOINT Management Full timeJob Description Job Description Summary The Outpatient UM Coordinator provides effective communication between MSO, IPA providers, and members to coordinate member care. Communication to include accessibility to care, validating contract entities, and ensuring timeliness standards are met. The Outpatient UM Coordinator reports directly to the Outpatient Lead...
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Provider Support Representative
2 days ago
Los Angeles, United States MedPOINT Management Full timeJob DescriptionJob DescriptionSummaryUnder the Provider Network Operations (PNO) Provider Network Management Supervisor's general direction, the PNO Provider Support Representative is responsible for responding to all PNO department queue incoming calls in a courteous and efficient manner, and triaging Client IPA, Provider and Provider office staff...
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Outpatient UM Coordinator
2 months ago
Los Angeles, United States MedPOINT Management Full timeJob DescriptionJob DescriptionSummaryThe Outpatient UM Coordinator provides effective communication between MSO, IPA providers, and members to coordinate member care. Communication to include accessibility to care, validating contract entities, and ensuring timeliness standards are met. The Outpatient UM Coordinator reports directly to the Outpatient Lead...
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Outpatient UM Coordinator
2 months ago
Los Angeles, United States MedPOINT Management Full timeJob DescriptionJob DescriptionSummaryThe Outpatient UM Coordinator provides effective communication between MSO, IPA providers, and members to coordinate member care. Communication to include accessibility to care, validating contract entities, and ensuring timeliness standards are met. The Outpatient UM Coordinator reports directly to the Outpatient Lead...
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Provider Support Representative
1 month ago
Los Angeles, United States MedPOINT Management Full timeJob DescriptionJob DescriptionSummaryUnder the Provider Network Operations (PNO) Provider Network Management Supervisor's general direction, the PNO Provider Support Representative is responsible for responding to all PNO department queue incoming calls in a courteous and efficient manner, and triaging Client IPA, Provider and Provider office staff...
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Customer Solution Center Member Navigator Ii
3 weeks ago
Los Angeles, United States L.A. Care Health Plan Full timeCustomer Solution Center Member Navigator II- Palmdale (onsite) **Job Category**:Customer Service**Department**:Even MORE Outreach & Service**Location**:Los Angeles, CA, US, 90017**Position Type**:Full Time**Requisition ID**:11326**Salary Range**: $60,778.00 (Min.) - $75,950.00 (Mid.) - $91,166.00 (Max.)- Established in 1997, L.A. Care Health Plan is an...
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Contract Services Coordinator
2 weeks ago
Los Angeles, United States USC Full timeCapitalizing on over 140 years of history and tradition in downtown Los Angeles, the **University of Southern California (USC)** has embarked on an unprecedented period of expansion. USC is now poised to take its place as the preeminent research institution of the 21st century and we are looking for skilled, motivated professionals to help forge the future...
