Top Provider Network Executive plans and directs all aspects of an organization's provider network function. Responsible for developing the network and negotiating and administering contracts. Being a Top Provider Network Executive oversees provider relations and monitors and directs all provider services. Requires a bachelor's degree. Additionally, Top Provider Network Executive typically reports to a top management. The Top Provider Network Executive manages a departmental function within a broader corporate function. Develops major goals to support broad functional objectives. Approves policies developed within various sub-functions and departments. To be a Top Provider Network Executive typically requires 8+ years of managerial experience. Comprehensive knowledge of the overall departmental function. (Copyright 2024 Salary.com)
Salary: $22.56 - $31.58 Hourly
The Provider Network Support Coordinator is responsible for coordinating daily activities within CenCal Health including, but not limited to: enrolling and maintaining the Provider Portal user accounts, updating the Provider Manual as needed, maintaining the provider section of the CenCal Health website, including development and/or updating of documents used for trainings and more. This position will coordinate mailing and announcements, support the Provider Relations team with incoming inquiries received via email or phone, and ensure efficient coordination amongst the teams in the Provider Services department and cross-departmentally.
Duties and Responsibilities
This position is responsible for the following tasks:
Coordinate the updating of the Provider section of the CenCal Health Website
Coordinate Portal user enrollment for both contracted and non-contracted providers and maintain/update accounts as requested
Coordinate and review Provider Announcements and other mailings (letters, emails, faxes) to ensure professionalism, tone, and consistency of messaging
Coordinate the publication of Provider Bulletins, training documents, and brochures
Support the development of Network related responses to regulatory inquiries and audits
Participate in special projects and assignments as required
Provides general customer service to contracted and non-contracted providers:
Provide backup for Representatives, including but not limited to fielding incoming calls, checking Central Line voicemail, and assuring prompt delivery to the proper party at regular intervals
Respond and coordinates response to the Provider Services email
Documents interactions with providers in a timely fashion
Represents the Provider Services Department with professionalism
Assists in assigning website accounts and troubleshooting website issues
Educates and trains providers on transaction services and answers website questions
Maintains department policies & procedures pertinent to the position. Completes other projects as required
Coordinates general customer service to contracted and non-contracted providers
Other duties as assigned
Knowledge/Skills/Abilities
Must possess high energy, a positive attitude and a customer service focus
Must be detail-orientated and able to prioritize assigned projects based on importance and deadlines
Must be exceedingly well organized and disciplined and be an exceptional multi-tasker
Excellent effective oral and written communication skills required
Must have the ability to interact with staff (at all levels) in a fast-paced environment, sometimes under pressure, while remaining flexible, proactive and resourceful
Strong problem-solving skills required
Knowledge and proficiency in the operation of personal computers is required, including advanced skills in MS Office
Experience with using a provider Portal is preferred
Requires general knowledge of standard office equipment
Must have experience in business or technical writing with a strong skill in correct grammar
Must be able to work full-time
Education and Experience
Bachelor’s Degree preferred
AA Degree required with equivalent experience
Three to five (3-5) years experience working in healthcare, Managed Care preferred
Portal experience desired
Three to five (3-5) years experience in Customer Service
Three to five (3-5) years of experience working with technical documentation in an administrative role is desired
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