Job description

Value Based Care Services – Remote
As the Provider Operations Coordinator you will be responsible for the day-to-day administration of operational aspects between Arcadia, clients and assigned heath plan(s). Provider Operations Coordinators must be familiar with client health plan contract obligations.

What you’ll be doing

• Reporting and client deliverables
• Medical management operations (only operational, not clinical aspects)
• Regulatory and contract compliance for functions delegated to Arcadia
• Capitation processes and reconciliations
• Provider relations activities and network management activities
• Analyze data and information, including written analysis
• Establish and maintain excellent rapport with clients
• Other duties and responsibilities as assigned

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What success looks like…*

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…in 3 months*

• Learn applicable systems and Provider Operations workflows
• Consistently enter an average of 10 provider adds per hour using the Provider Add Module
• Assist with Submission Oversight Reports

…in 6 months

• Assist with Capitation workflow
• Independently work Submission Oversight Reports and Provider Operations Department Audit Reports
• Assist Clients with provider contracting and oversight inquiries
• Consistently enter an average of 18 provider adds per hour using the Provider Add Module

…in 12 months

• Considered a subject matter expert for provider record entry

o Consistently enter an average of 25 provider adds per hour, or 2-3 minutes per provider add, using the Provider Add Module

• Create impact reports
• Other duties assigned by the manager of the department

What You'll Be Doing

• Reporting and client deliverables
• Medical management operations (only operational, not clinical aspects)
• Regulatory and contract compliance for functions delegated to Arcadia
• Analyze data and information, including written analysis
• Establish and maintain excellent rapport with clients
• Capitation processes and reconciliations
• Provider relations activities and network management activities
• Other duties and responsibilities as assigned.

You'll Need To Have

• At least 3 –6+ years of related work experience in the healthcare network management field
• Analytical thinking and planning skills
• Ability to manage multiple priorities in a dynamic environment
• Ability to adapt to an evolving work environment
• Expert level experience with all Microsoft Office applications, including Word, Excel and Access
• Ability to ensure completion of projects and assignments
• Able to problem solve, exercise initiative and make decisions
• Excellent communication skills with outgoing client personality
• Experience with reading and writing provider payment contracts
• Experience managing mid-size to large scale projects preferred
• Excellent Communication Skills

Would Love For You To Have

• Associate’s or Bachelor’s Degree, or equivalent in education and experience in healthcare field
• Experience and knowledge with Medicare Advantage strongly encouraged
• Experience in high level decision making preferred

What You'll Get

• Learn the life of a Contract Management firm with Independent Physician Associations across Illinois.
• Encouragement to bring ideas to the table.
• Opportunity to be part of a team creating automated processes to drastically improve healthcare.
• Receive cash compensation with health, dental, and other benefits.
• Amazing benefits package including flextime time off.

About Arcadia
Arcadia.io helps innovative healthcare systems and health plans around the country transform healthcare to reduce cost while improving patient health. We do this by aggregating massive amounts of clinical and claims data, applying algorithms to identify opportunities to provide better patient care, and making those opportunities actionable by physicians at the point of care in near-real time. We are passionate about helping our customers drive meaningful outcomes. We are growing fast and have emerged as the market leader in the highly competitive population health management software and value-based care services markets, and we have been recognized by industry analysts KLAS, IDC, Forrester and Chilmark for our leadership. For a better sense of our brand and products, please explore our website, our online resources, and our interactive Data Gallery.

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This position is responsible for following all Security policies and procedures in order to protect all PHI under Arcadia's custodianship as well as Arcadia Intellectual Properties. For any security-specific roles, the responsibilities would be further defined by the hiring manager._

Job Type: Full-time

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