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Coordinator, Provider Network (100%)- Adena Health Plan

Job Description

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 Job Title: Coordinator, Provider Network (100%)- Adena Health Plan
 Company Name: Adena Health System
 Employment Type: Full Time
 Location: CHILLICOTHE, OH, United States
 Department: Adena Health Plan
 Salary: Highly Competitive
 Shift Hours/ Days: 8-5
 Hours/Pay Period: 80
 Degree Required: None Specified
 Job ID: 30.94500-01370
 Date Posted: Jul 10, 2013
 Years Experience: unspecified
 Note:  Please read the complete description below before applying for this job.
  Complete Description

This position serves as the main resource of the Provider Network Development and Implementation activities for Adena Care.  Reports directly to the Executive Director and assists in executing the strategic direction of and coordinates the day to day provider network development and implementation activities.  Coordinates provider credentialing processes pursuant to NCQA guidelines.  Under the direction of the Executive Director, this position is responsible for overseeing the processes to implement and maintain signed provider agreements into the database or other systems to record provider demographics, contracted rates, and other information necessary for accurate claims adjudication. Assists with developing member access strategies and monitors network adequacy. This position may also be assigned to negotiate provider contract language and rates under established parameters and protocols.

Required Education, Credentials and Certifications: Associate Degree in Healthcare Administration or related field. Bachelor's degree preferred.

Experience: Minimum 2 years experience in provider network development and/or credentialing with a hospital or health plan. Hospital/physician contracting experience preferred. Other related healthcare business experience.

Adena Health System is an equal opportunity employer. We consider applicants for all positions without regard to race, color, religion, national origin, age, veteran status, the presence of a non-job related medical condition or disability or any other legally protected status