Regal Medical Group
Coordinator, Contracting Provider Relations
Regal Medical Group, Orange, California, United States, 92613
Position Summary:
The Contracts Coordinator serves as the internal liaison, responsible for maintaining, processing and reviewing department databases and daily reporting to support the Contracting Department in achieving overall network growth and development goals.
Essential Duties and Responsibilities include the following: Assist in Network growth and development to include preparation of contract packets for recruitment projects. Under the supervision of the Contracts Manager, responsible to work with Network Managers and providers to obtain proper signatures and documentation to effectively process newly recruited or existing providers. Maintaining and updating the appropriate databases and department tools with statuses. Coordinate the receipt and processing of all provider contracts, credentialing materials and related correspondence. Responsible for timely and accurate completion of PACFs related to incoming documentation received from providers regarding changes to their demographic information in the credentialing and provider network databases. Responsible for initial review of all credentialing applications prior to submittal to RMG Contracts for completion and accuracy. Working collaboratively with Director of Contracting, Contracts Manager, Network Managers and other Network Management staff during the contracting process to ensure department goals and requirements are being met. Manage the initial submission of provider profiles to Health Plans and follow up as needed to ensure PCPs, Specialists and Ancillary providers are properly activated in plan databases. Engage in daily interaction with regional providers to support ongoing relationship management Ensure contract compliance and adherence to DMHC, DHS, CMS and other regulatory agencies as required by contracting HMOs. Interface with internal departments such as Database Management, Claims, Customer Service and Medical Management. The pay range for this position at commencement of employment is expected to be between $23 per hour - $25 per hour; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, licensure, skills, and experience.
The total compensation package for this position may also include other elements, including a sign-on bonus and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered.
Details of participation in these benefit plans will be provided if an employee receives an offer of employment.
If hired, employee will be in an "at-will position" and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.
As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare & Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success.
Full Time Position Benefits:
The success of any company depends on its employees. For us, employee satisfaction is crucial not only to the well-being of our organization, but also to the health and wellness of our members. As such, we are firmly dedicated to providing our employees the options and resources necessary for building security and maintaining a healthy balance between work and life.
Our dedication to our staff is evident in our comprehensive benefits package. We offer a very generous mixture of benefits, including many employer-paid options.
Health and Wellness:
Employer-paid comprehensive medical, pharmacy, and dental for employees Vision insurance Zero co-payments for employed physician office visits Flexible Spending Account (FSA) Employer-Paid Life Insurance Employee Assistance Program (EAP) Behavioral Health Services Savings and Retirement:
401k Retirement Savings Plan Income Protection Insurance Other Benefits:
Vacation Time Company celebrations Employee Assistance Program Employee Referral Bonus Tuition Reimbursement License Renewal CEU Cost Reimbursement Program Business-casual working environment Sick days Paid holidays Mileage Employer will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the LA City Fair Chance Initiative for Hiring Ordinance.
Education and/or Experience:
Minimum of 2 years of relevant work experience in Network Management or Contracting within a managed care setting, health plan, or large medical group administration. Knowledge of contracting principles and tools. Excellent verbal and written communication skills. Proficient in MS Office programs, including Word, Excel, Outlook, Access and PowerPoint. Ability to multitask effectively, manage multiple priorities and meet deadlines in a fast-paced environment where daily priorities may change. Strong time management and organizational skills. Strong attention to detail: meticulously manage and review complex information to ensure accuracy and completeness, especially when handling contracts, data entry and reporting. Critical thinking: analyze situations, identify issues and develop effective solutions independently or collaboratively to support process improvements and decision-making. Self-discipline: maintain focus and productivity while managing multiple tasks and deadlines, demonstrating reliability and accountability in a dynamic work environment.
The Contracts Coordinator serves as the internal liaison, responsible for maintaining, processing and reviewing department databases and daily reporting to support the Contracting Department in achieving overall network growth and development goals.
Essential Duties and Responsibilities include the following: Assist in Network growth and development to include preparation of contract packets for recruitment projects. Under the supervision of the Contracts Manager, responsible to work with Network Managers and providers to obtain proper signatures and documentation to effectively process newly recruited or existing providers. Maintaining and updating the appropriate databases and department tools with statuses. Coordinate the receipt and processing of all provider contracts, credentialing materials and related correspondence. Responsible for timely and accurate completion of PACFs related to incoming documentation received from providers regarding changes to their demographic information in the credentialing and provider network databases. Responsible for initial review of all credentialing applications prior to submittal to RMG Contracts for completion and accuracy. Working collaboratively with Director of Contracting, Contracts Manager, Network Managers and other Network Management staff during the contracting process to ensure department goals and requirements are being met. Manage the initial submission of provider profiles to Health Plans and follow up as needed to ensure PCPs, Specialists and Ancillary providers are properly activated in plan databases. Engage in daily interaction with regional providers to support ongoing relationship management Ensure contract compliance and adherence to DMHC, DHS, CMS and other regulatory agencies as required by contracting HMOs. Interface with internal departments such as Database Management, Claims, Customer Service and Medical Management. The pay range for this position at commencement of employment is expected to be between $23 per hour - $25 per hour; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, licensure, skills, and experience.
The total compensation package for this position may also include other elements, including a sign-on bonus and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered.
Details of participation in these benefit plans will be provided if an employee receives an offer of employment.
If hired, employee will be in an "at-will position" and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.
As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare & Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success.
Full Time Position Benefits:
The success of any company depends on its employees. For us, employee satisfaction is crucial not only to the well-being of our organization, but also to the health and wellness of our members. As such, we are firmly dedicated to providing our employees the options and resources necessary for building security and maintaining a healthy balance between work and life.
Our dedication to our staff is evident in our comprehensive benefits package. We offer a very generous mixture of benefits, including many employer-paid options.
Health and Wellness:
Employer-paid comprehensive medical, pharmacy, and dental for employees Vision insurance Zero co-payments for employed physician office visits Flexible Spending Account (FSA) Employer-Paid Life Insurance Employee Assistance Program (EAP) Behavioral Health Services Savings and Retirement:
401k Retirement Savings Plan Income Protection Insurance Other Benefits:
Vacation Time Company celebrations Employee Assistance Program Employee Referral Bonus Tuition Reimbursement License Renewal CEU Cost Reimbursement Program Business-casual working environment Sick days Paid holidays Mileage Employer will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the LA City Fair Chance Initiative for Hiring Ordinance.
Education and/or Experience:
Minimum of 2 years of relevant work experience in Network Management or Contracting within a managed care setting, health plan, or large medical group administration. Knowledge of contracting principles and tools. Excellent verbal and written communication skills. Proficient in MS Office programs, including Word, Excel, Outlook, Access and PowerPoint. Ability to multitask effectively, manage multiple priorities and meet deadlines in a fast-paced environment where daily priorities may change. Strong time management and organizational skills. Strong attention to detail: meticulously manage and review complex information to ensure accuracy and completeness, especially when handling contracts, data entry and reporting. Critical thinking: analyze situations, identify issues and develop effective solutions independently or collaboratively to support process improvements and decision-making. Self-discipline: maintain focus and productivity while managing multiple tasks and deadlines, demonstrating reliability and accountability in a dynamic work environment.