Network Coordinator

1 day ago

Northridge, United States Regal Medical Group Full time
Job Description

Position Summary:

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 $22-$25 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)

  • Inpatient Case Manager

    4 days ago

    Northridge, United States AMI Network Full time $35 - $50

    Position Summary:The information below covers the role requirements, expected candidate experience, and accompanying qualifications.The Inpatient Case Manager is responsible for assessing, planning, intervening, monitoring, evaluating, and documenting patient care during hospitalization. They collaborate with physicians and healthcare providers to develop a...

  • RN Case Manager Care Coordinator

    3 months ago

    Northridge, United States Unavailable Full time

    Overview Founded in 1955, Dignity Health – Northridge Hospital Medical Center is a 394-bed, acute care, nonprofit community hospital located in Northridge, California.  The hospital offers a full complement of award winning services, including the Leavey Cancer Center, a cardiovascular center, stroke center, the Center for Assault Treatment Services, a...

  • Adult Care Coordinator

    1 week ago

    Northridge, California, United States ETTA Full time

    About the RoleWe are looking for an enthusiastic and empathetic individual to fill the position of Direct Support Professional at ETTA.The successful candidate will work one-on-one with individuals in the I/DD community, engaging, guiding, and inspiring them to increase community involvement, grow their social network, develop opportunities, and achieve...

  • Business Development Representative

    4 weeks ago

    Northridge, California, United States Institute of Inspection , Cleaning and Restoration Certification Full time

    Job Summary:We are seeking a highly motivated and results-driven Business Development Representative to join our team. As a key member of our sales team, you will be responsible for building strong relationships with current and potential clients, driving new business, and closing profitable jobs.Key Responsibilities:Build strong relationships with current...

  • RN Neonatal ICU

    2 weeks ago

    Northridge, United States Dignity Health Full time

    **Overview** Founded in 1955 Dignity Health - Northridge Hospital Medical Center is a 394-bed acute care nonprofit community hospital located in Northridge California. The hospital offers a full complement of award winning services including the Leavey Cancer Center a cardiovascular center stroke center the Center for Assault Treatment Services a pediatric...

  • Engineering/Maintenance Manager

    4 months ago

    Northridge, United States Purcell International Group Full time

    As a result of sales growth and expansion our client, a growing privately held company doing steady yearly growth, has hired us to find an exceptional Engineering/Maintenance Manager. Our client is a highly regarded industry leader in the cosmetic manufacturing industry. This company is ranked in the Top 100 Best and their products can be found in Ultra,...

  • RN Surgery

    3 months ago

    Northridge, United States Unavailable Full time

    Overview Founded in 1955 Dignity Health – Northridge Hospital Medical Center is a 394-bed acute care nonprofit community hospital located in Northridge California. The hospital offers a full complement of award winning services including the Leavey Cancer Center a cardiovascular center stroke center the Center for Assault Treatment Services a pediatric...

  • Pediatric Critical Care RN

    2 weeks ago

    Northridge, California, United States Common Spirit Full time

    Career Opportunities:We invite skilled and compassionate emergency nurses to join our team at Northridge Hospital Medical Center. As a key member of our emergency department, you will provide critical care to patients in need, collaborating with a multidisciplinary team to deliver exceptional patient outcomes.Responsibilities:Assess and evaluate patient...

  • Pediatric Intensive Care Nurse

    3 weeks ago

    Northridge, California, United States Common Spirit Full time

    Overview">Dignity Health - Northridge Hospital Medical Center is a 394-bed acute care nonprofit community hospital located in California. We share a rich legacy with Dignity Health, one of the nation's five largest health care systems.">We are part of a 21-state network of nearly 9000 physicians, 62000 employees, and more than 400 care centers. Our Pediatric...

  • Community Advocate

    2 days ago

    Northridge, United States Dignity Health Full time

    Overview Founded in 1955 Dignity Health – Northridge Hospital Medical Center is a 394-bed acute care nonprofit community hospital located in Northridge California. The hospital offers a full complement of award winning services including the Leavey Cancer Center a cardiovascular center stroke center the Center for Assault Treatment Services a pediatric...

  • Manager Risk Management

    2 days ago

    Northridge, United States Dignity Health Full time

    Overview Founded in 1955 Dignity Health – Northridge Hospital Medical Center is a 394-bed acute care nonprofit community hospital located in Northridge California. The hospital offers a full complement of award winning services including the Leavey Cancer Center a cardiovascular center stroke center the Center for Assault Treatment Services a pediatric...

  • Community Advocate

    2 days ago

    Northridge, United States Unavailable Full time

    Overview Founded in 1955 Dignity Health – Northridge Hospital Medical Center is a 394-bed acute care nonprofit community hospital located in Northridge California. The hospital offers a full complement of award winning services including the Leavey Cancer Center a cardiovascular center stroke center the Center for Assault Treatment Services a pediatric...

  • Review Nurse, Denial

    2 months ago

    Northridge, United States Regal Medical Group Full time

    Job DescriptionPosition Summary:The role of the Denial Nurse is to promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to denials. The Denial Nurse will review for appropriate care and setting and following guidelines/policies as it relates to denials. The Denial...

  • Manager Risk Management

    2 days ago

    Northridge, United States Unavailable Full time

    Overview Founded in 1955 Dignity Health – Northridge Hospital Medical Center is a 394-bed acute care nonprofit community hospital located in Northridge California. The hospital offers a full complement of award winning services including the Leavey Cancer Center a cardiovascular center stroke center the Center for Assault Treatment Services a pediatric...

  • Orthopedic Rehabilitation Specialist

    1 week ago

    Northridge, California, United States GrandCare Health Services Full time

    Company Overview">We are a leading provider of in-home physical therapy services, dedicated to delivering high-quality care and improving patient outcomes. Our team is comprised of experienced professionals who share a passion for providing exceptional patient care.Salary">The annual salary range for this position is $75,000 to $100,000, paid on a...

  • RN Orthopedics Acute

    2 weeks ago

    Northridge, United States Dignity Health Full time

    **Overview** Founded in 1955 Dignity Health - Northridge Hospital Medical Center is a 394-bed acute care nonprofit community hospital located in Northridge California. The hospital offers a full complement of award winning services including the Leavey Cancer Center a cardiovascular center stroke center the Center for Assault Treatment Services a pediatric...

  • Hospitalist Project Manager

    3 weeks ago

    Northridge, United States Regal Medical Group Full time

    Job DescriptionPosition Summary: The Inpatient Hospitalist Coordinator is responsible for completing non-clinical tasks related to supporting the Hospitalist Program, assisting Hospitalists and Hospitalist groups with administrative duties. These include performing all necessary functions working directly with the physicians and Medical Director of the...

  • Clinical Nurse Specialist RN NICU

    3 months ago

    Northridge, United States CommonSpirit Health Full time

    Overview: Founded in 1955 Dignity Health Northridge Hospital Medical Center is a 394-bed acute care nonprofit community hospital located in Northridge California. The hospital offers a full complement of award winning services including the Leavey Cancer Center a cardiovascular center stroke center the Center for Assault Treatment Services a pediatric...

  • Clinical Nurse Specialist RN NICU

    3 months ago

    Northridge, United States Unavailable Full time

    Overview Founded in 1955 Dignity Health – Northridge Hospital Medical Center is a 394-bed acute care nonprofit community hospital located in Northridge California. The hospital offers a full complement of award winning services including the Leavey Cancer Center a cardiovascular center stroke center the Center for Assault Treatment Services a pediatric...

  • Medical Claims Specialist

    1 month ago

    Northridge, United States Regal Medical Group Full time

    Job DescriptionPosition Summary: Provide daily supervision, leadership and coordination in the maintenance of Regal Medical Group’s claims processing system. Supports accuracy of member benefit set up, assignments, claims processing, financial accuracy and data integrity. Essential Duties and Responsibilities include the following:Implements data integrity...