Description
Title: Provider Demographic Management Coordinator
Location: Fountain Valley, CA / Predominantly Remote
Department: IPA - Provider Network
Status: Full-Time
Shift: Days (8hr)
Pay Range*: $24.01/hr - $34.81/hr
MemorialCare is a nonprofit integrated health system that includes four leading hospitals, award-winning medical groups – consisting of over 200 sites of care, and more than 2,000 physicians throughout Orange and Los Angeles Counties. We are committed to increasing access to patient-centric, affordable, and high-quality healthcare; your personal contributions are integral to MemorialCare's recognition as a market leader and innovator in value-based and other care models.
Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration, and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation, and teamwork.
Position Summary
The Provider Demographic Management Coordinator (PDM Coordinator) is responsible for generating Health Plan notifications including adds, changes and terms. PDM Coordinator catalogs and tracks all changes and ensures key updates are completed accordingly. In addition the PDM Coordinator will work directly with the Provider Demographic Specialist to ensure the accuracy of network provider information listed on the contracted health plans directories and websites. The PDM Coordinator will assist in maintaining accurate and updated provider matrixes and rosters on internal intranets as well as websites.
Essential Functions and Responsibilities of the Job
Familiar with regulatory standards including but not limited to: NCQA, ICE, DMHC, DHCS, CMS, and contracted health plans.
Use pertinent data and facts to identify and solve a range of problems within area of expertise.
Be at work and be on time
Follow company policies, procedures and directives
Interact in a positive and constructive manner
Prioritize and multitask
Effectively establish and maintain working relationships, and proves able to continually follow up with appropriate parties in order to achieve optimal results
Track, update, and audit provider information in database
Analyze problems by gathering all relevant information and come up with appropriate solutions
Pays close attention to detail, accuracy and completeness, and meets deadlines
Must understand basic computer logic, conditional statements
Placement in the pay range is based on multiple factors including, but not limited to, relevant years of experience and qualifications. In addition to base pay, there may be additional compensation available for this role, including but not limited to, shift differentials, extra shift incentives, and bonus opportunities. Health and wellness is our passion at MemorialCare—that includes taking good care of employees and their dependents. We offer high quality health insurance plan options, so you can select the best choice for your family. And there’s more...Check out our MemorialCare Benefits for more information about our Benefits and Rewards.
