Day Shift Description: WHO WE ARE MercyOne Population Health Services Organization (PHSO) is a clinically integrated network comprised of independent, owned, and managed affiliates. The Provider Network team is responsible for building and maintaining a robust network of high-quality partnered providers. We manage provider relationships, contracting, and the preferred payer agreements.
Additionally, we serve as a critical link between our providers and preferred payers, advocating on behalf of the network by escalating concerns, including claims-related issues, and following them through to effective resolution. POSITION PURPOSE This hybrid role works in office twice a week once trained and is an integral team member of MercyOne PHSO’s Operations team, the Provider Network and Operations Coordinator assists PHSO leadership on tasks as assigned.
Functions including oversight and management for the MercyOne Provider Network Directory, Compliance & auditing, and coordination of projects. Serves as a liaison between PHSO administration, Chapters, regulatory bodies, and MercyOne Partnered Provider organizations/providers as needed. This role is part of the MercyOne PHSO Operations team, reporting to the Provider Network Supervisor.
1. Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions. 2. Provider Network Support Serves as the key resource to implement and maintain an accurate, NCQA-compliant Provider Network Directory.
Develops and maintains intake/assessment forms to gather key information to support the Provider Network Directory. Coordinates with Medical Staff Offices, Physician Recruitment and Employment, and Clinic Managers to obtain all required information as part of recruitment processes. Assists in the management of PHSO Participant Agreements and Network Contracting.
Assists in the investigation and response to member inquiries related to the Provider Network and Directory. 3. Compliance Support Manages and monitors electronic Policy and Procedure handbook. Completes documentation and user audits according to federal and state health statutes, as well as third party control provisions.
Assists the ACO Compliance Official in evaluating and responding to inquiries from governing bodies/regulatory agencies (i.e.: CHAN, Centers for Medicare and Medicaid Services) Assists in the on-boarding of new ACO Participants and Providers. Responds to PHSO email and phone inquiries from patients, providers and regulatory bodies. 4. Project & Meeting Support Assists with agenda creation, presentation of materials, and minutes for key meetings, including Provider Network Council and Chapter Governance Meetings.
Assists PHSO leadership with special projects, including the tracking of deliverables, compiling information and reports, etc. Acts as resource in various committees and meetings to coordinate changes in ACO processes. Maintains PHSO directories, websites, and Sharepoint sites with education content. 5.
Other duties as needed and assigned by the manager. 6. Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.
1. Bachelor’s degree preferred. In lieu of educational requirements, previous work history and years of experience may be considered. 2.
Minimum of one year of experience with a healthcare system, health plan or healthcare accrediting body. Prior experience in project coordination preferred. 3. Experience in ACOs and knowledge of value-based care is preferred. 4.
Demonstrated proficiency in Microsoft applications (e.g., Word, Excel, PowerPoint) required. 5. Strong demonstrated verbal communication and critical thinking skills required. 6. Excellent verbal and writing skills required. 7.
Excellent organizational skills and attention to detail required. 8. Ability to manage and prioritize multiple deliverables required. 9. Excellent project management skills strongly preferred. 10.
Demonstrated presentation skills preferred. 11. Must be comfortable operating in a collaborative, shared leadership environment. 12. Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Trinity Health and MercyOne.
Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.