Description:
Summary/Position Objectives:
This position reports to the Network Manager and is responsible for ensuring accurate provider data is obtained and maintained in the Maryland Physicians Care (MPC) operating system and online provider directory. The incumbent will provide the Network Management team with detail-oriented administrative support to include provider data entry, provider data auditing, provider data corrections, completing and uploading forms and service tickets, submitting contracts, letters, and packets, and other administrative duties such as serving as the initial phone contact for the department and composing related correspondence. The incumbent will assist the manager with internal projects and generating reports. The incumbent will also provide back-up support to the Provider and Facility Services Coordinator.
About Maryland Care Management, Inc. (MCMI)
Maryland Care Management, Inc. (MCMI) manages Maryland Physician Care's (MPC) statewide provider network of hospitals and physicians. Maryland Physicians Care has been providing services to the HealthChoice Medicaid populations since 1996, and we are proud of our footprint in the community. With over 230,000 members, MPC consistently has been one of MD's largest Medicaid-managed care organizations.
Why join us?
MCMI recognizes the importance of flexibility and offers multiple work arrangements. Along with competitive pay, we offer excellent benefits (medical, dental, and vision plans, 100% employer Term Life Insurance, Short and Long-Term Disability, 401k Employer Match up to 4%) as well as 20 days of PTO, and tuition assistance/professional development plans.
Your future colleagues at MCMI are welcoming, friendly, and eager to help each other succeed. We are committed to Diversity, Equity, and Inclusion, providing organizational-wide social opportunities, and constantly improving our ongoing efforts to positively impact our members' lives.
What You'll Do:
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Assists providers with the completion of credentialing forms.
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Collects required documents for initial credentialing.
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Audits credentialing packets for accuracy.
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Completes and uploads provider credentialing forms.
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Creates and sends credentialing status letters to providers within required timeframes.
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Creates service tickets for new providers and those joining existing groups.
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Audits provider rosters for changes.
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Follows up on missing contracting documents
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Composes provider network declination letters utilizing appropriate template.
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Provides support to Network Manager with project-specific tasks; generating reports as needed.
Requirements:
Knowledge and Skills:
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Work requires demonstrated experience with Microsoft Office 365 to include excellent utilization of Word, Excel, Outlook, Teams, and Adobe applications.
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Work requires strong ability to collect data, complete a detailed review of data for accuracy and completion, create timely tickets to ensure accurate data is in the MPC operating system and online directory.
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Work requires excellent interpersonal skills to effectively interface with all levels of staff, providers, and business-related associates.
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Work requires excellent verbal and written communication skills; ability to present information effectively.
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Ability to assimilate information and learn quickly.
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Ability to multi-task and organize, coordinate priorities.
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Ability to be a positive team player; able to manage project time constraints.
Education and Work Experience:
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Work requires the skills generally acquired through the completion of a High School diploma or GED.
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Requires a minimum of 3 years of administrative experience within a healthcare environment. Credentialing or provider data maintenance experience (preferred).
EEOC Statement:
Following applicable federal, state, and local laws, MCMI prohibits discrimination in employment based on race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age, disability, genetic information, or any other characteristic protected by law. This commitment extends to all aspects of employment, including hiring, promotion, compensation, benefits, training, social and recreational programs, and all other conditions and privileges of employment.
As a healthcare organization, we recognize the vital importance of inclusivity in delivering quality care to our patients. We strive to foster an environment where individuals of all backgrounds feel respected, valued, and supported. We aim to better comprehend the unique needs of our patients and provide healthcare services that are culturally competent and sensitive.
We encourage candidates from all backgrounds to apply and join us in our mission to provide compassionate and inclusive healthcare. We believe that a diverse workforce enriches our organization and allows us to better understand, connect with, and serve our diverse patient population.
