The Provider Network Coordinator (PNC) is responsible for a wide range of activities to support, develop and maintain service relationships with all participants (physicians, hospitals and health systems, providers, and administrators) of the MSO provider network. Primary focus will be on timely completion of provider credentialing and re-credentialing activities, according to Health Plan, State, Federal and NCQA requirements, for over 1,000 network providers. The PNC is responsible managing and maintaining accurate data related to the provider and groups within the MSO provider network. This includes being the main point of contact for all provider information and collaborating with contracted health plans, internal teams and directly with providers to ensure accurate data collection and exchange.
The PNC ensures MSO network providers meet all credentialing and licensing requirements and is responsible for continuous monitoring of the entire provider network. The PNC plays a crucial role in building and sustaining a high-quality provider network by overseeing the data accuracy and credentialing of all healthcare professionals.|
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This is an FLSA NON-exempt position.
This is not an OSHA high-risk position.
NEMS is proud to be an Equal Opportunity Employer welcoming diversity in our workforce. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
NEMS BENEFITS: Competitive benefits, including free medical, dental and vision insurance for employee, spouse and/or children; and company contribution to 401(k)