People are the most important asset of Imperial, for this reason the difference and plurality of people, equality of opportunities, non-discrimination and inclusion in the workplace are priority and strategic factors in the Organization. Imperial maintains a strong will to promote Diversity, Equity, and Inclusion, through inclusive leadership as a lever change and business sustainability.
Imperial Health Plan of California, Inc. is approved by California Department of Managed Health Care to offer full-service Medicare Advantage coverage, including a Medicare Advantage Prescription Drug plan, and a Chronic Condition Special needs plan over numerous counties in California. Through its affiliate, Imperial Insurance Companies, Imperial also offers Medicare Advantage plans in Texas, New Mexico, Utah, and Arizona.
Our Mission: To deliver valuable care so that members are healthy in body, mind, and spirit to achieve their inherent potential.
Our Vision: To deliver value based care that is clinically effective, sustainable, and achieves exceptional outcome.
JOB SUMMARY: Will provide support to Contracting Manager in closing gaps and developing the network. Researching and contracting all specialties and Hospitals in our current counties/states and upcoming states and counties.
ESSENTIAL JOB FUNCTIONS:
1. Will use Microsoft Word/Excel to put together and track emails/ faxes and the necessary paperwork for credentialing and contracting as assigned.
2. Responsible for following up with the providers to collect all paperwork for contracting. Getting the contracts signed.
3. Assist with requests that come through Contracting:
A. Contracting (Expansion and current service areas)
B. Collect data from the Providers for Credentialing
C. Respond for LOA requests.
D. Network Gaps analysis and recovery
E. Answer provider inquiries on status of credentialing
F. Research and call potential new providers for contracting in all service areas new and existing.
4. Assure that all contracts are completed and given to contracting coordinator for upload.
5. Find providers for any incidents that should come into the Contracting queue.
6. Provides a daily/weekly summary of the success rate of the above by geographic region and specialty.
7. Frequently contacts providers via phone to follow up on contracts and credentialing documentation.
8. Travel may be required to visit provider offices to obtain necessary documentation or contracts.
9. Travel may be required to the new counties/States to recruit for network.
10. Supports the Contracting needs of the Provider Network Management department.
EDUCATION/EXPERIENCE:
· High school graduate or equivalent.
· At least 2-3 years prior Health Plan Contracting-Specialists, Hospitals and Primary Care.
SKILLS/KNOWLEDGE/ABILITY:
· Proficient with Microsoft Suite (Word, Excel, etc.)
· Strong phone/customer service skills
· Must be detail orientated.
Job Type: Full-time
Pay: $23.00 – $27.00 per hour
Benefits:
Schedule:
Experience:
Work Location: Remote
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