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Coordinator Provider Network

AmeriHealth Caritas

Remote · USJobSeen 3w agoSeen in employer's feed 1 day ago

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At a glance

Compensation
No compensation found
Location
Remote · US
Work Authorization
Not specified

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Job overview

The Provider Network Coordinator provides operational and administrative support to the Provider Network Management team and providers. The role coordinates network activities, maintains provider data and contract records, tracks and helps resolve issues, and supports initiatives related to provider satisfaction, education, communication, and continuous improvement. It is fully remote for associates located in Ohio, with monthly meetings as needed in Dublin, Ohio.

Skills & qualifications

RequiredNice to have

Skills

Organizational SkillsCoordinationAttention to DetailTask PrioritizationWritten CommunicationVerbal CommunicationCollaborationHealthcare OperationsProvider NetworksClaimsCredentialingEnrollment ProcessesDatabase ManagementTracking ToolsMicrosoft OfficeProblem SolvingCustomer Service

Qualifications

High School Diploma or GEDAssociate's Degree1 Year Healthcare Operations Experience

Full job description

Role Overview: The Provider Network Coordinator provides essential operational and administrative support to the Provider Network Management team and providers by coordinating, ensuring accurate data management, resolving issues, tracking activities, and executing initiatives related to provider network development, provider satisfaction, education, communication, and ongoing network operations.

Work Arrangements:

  • Remote - This position is fully remote; the associate must be located in Ohio (OH) and attend monthly meetings as needed in Dublin, OH.

Responsibilities:

  • Support provider network development and management strategies through coordination, tracking, and follow‑up activities.

  • Assist leadership with departmental initiatives related to provider satisfaction, education, and communication.

  • Support the intake, tracking, and management of provider issues, including maintaining provider tracking databases as applicable.

  • Help create processes that support continuous improvement, including identifying improvement opportunities and assisting providers with developing, implementing, monitoring, and tracking action plans.

  • Perform a variety of administrative and clerical duties to support Provider Network Management staff, ensuring efficient daily operations.

  • Serve as a resource to Network Management Account Executives for lower‑complexity contracting, provider setup questions, and issue resolution.

  • Verify and update provider demographics, this information, and assist with status updates.

  • As applicable, prepare and coordinate panel adds, panel holds, changes, member reassignments, and member interventions in accordance with state requirements.

  • Maintain a general operational understanding of provider‑related processes, including claims, payment integrity, provider data management, credentialing, appeals, and dispute resolution.

  • Update and maintain the provider contract database, ensuring accuracy and adherence to established timelines.

Education & Experience:

  • High school diploma or GED required.

  • Associate’s degree preferred.

  • 1 year of experience in healthcare/managed care operations, provider services, network management, or an administrative support role required.

Skills & Abilities:

  • Strong organizational and coordination skills with attention to detail.

  • Ability to manage multiple tasks and priorities in a fast‑paced environment.

  • Effective written and verbal communication skills.

  • Ability to work collaboratively with internal teams and external provider partners.

  • Basic understanding of healthcare operations, particularly provider networks, claims, credentialing, and enrollment processes.

  • Proficiency with databases, tracking tools, and Microsoft Office applications.

  • Problem‑solving mindset with the ability to escalate issues appropriately.

  • Strong customer service orientation with a focus on provider satisfaction.

As a company, we support internal diversity through:

Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.

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