GENERAL SUMMARY
Assists in the development and management of provider and hospital networks pertaining to fully insured, Health Plan, PPO, corporate accounts, lease networks, workers’ compensation, and behavioral health.
ESSENTIAL RESPONSIBILITIES
- Contacts providers by telephone, mail, or in person to solicit participation in the network. Explains the network and its requirements for participation; answers questions and communicates benefits of joining the network.
- Coordinates telemarketing and direct mail campaigns to expand the provider and hospital networks within an assigned market area to meet specific demographic, geographic and/or specialty objectives.
- Responds to and resolves provider questions, requests for information, and contractual interpretation inquiries in a timely manner.
- Reviews provider applications and applies standard procedures for credentialing provider applications.
- Maintains accurate provider information in the database.
- Manages new and existing provider group relationships including data management issue resolution and annual audits.
- May perform research, rate analysis, and data analysis for market and hospital development as necessary.
- May assist with individual and group physician recruitment.
- Performs other duties as required.
Qualifications:
JOB SPECIFICATIONS
- Associate's degree or equivalent experience.
- Previous related business or health care experience required, preferably in provider relations, database management, provider credentialing, or provider recruitment capacity. Entry level for employees with a Bachelor’ degree.
- Excellent written and verbal communication skills.
- Proficiency with standard desktop software applications such as Word, Access and Excel.
- Must be able to organize and analyze data.
- Occasional travel may be required.Coventry Health Care is an Affirmative Action/Equal Opportunity Employer, and we are committed to building a talented and diverse team.
Job: Administrative Support Workers
Primary Location: Austin, TX, US
Organization: 51000 - MHNet Specialty Services, LLC
Schedule: Full-time
Job Posting: 2013-02-08 00:00:00.0
Job ID: 1310492




















