Healthfirst Network Management Operations Coordinator in New York, New York

The Network Management Operations Coordinator is responsible for all of the administrative contracting activities, including but not limited to the reviewing of new and existing provider applications and ensuring they are complete and accurate. Obtaining necessary credentialing documents required for verification that will assist in determining whether a Provider meets specific company and other regulatory agency requirements. Will work closely with various: Hospitals, Physicians/Physician groups and staff, Network Management Department, Provider Operations Department, Credentialing department.

  • Processes high volume and time sensitive provider applications and contracts.

  • Coordinates with hospital/clinic, medical staff, and practitioners to complete privileging process, including any additional documentation, verifications, references, and applications necessary

  • Receives and reviews applications/contracts as well as other documents required to assess whether providers meet the criteria for participation in the HF network.

  • Preparing information for reporting purposes and conducting routine investigations of the online Provider directory and other internal systems to ensure that the Provider data is reflected correctly.

  • Works in coordination with Network Management staff to finalize provider applications and contracts and to ensure required approval is obtained.

  • Maintain tracking system in of follow up items, corrective action plans from regulatory agencies and collaborate closely with Hospital Relations team and other internal stakeholders to ensure that deadlines are being met.

  • Coordinates file review and approval by Credentialing Manager as required.

  • Additional duties as assigned

  • AA/AS and related experience

  • Bachelor’s Degree

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

If you have a disability under the Americans with Disability Act or a similar law, and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 1-212-801-6000. In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.

EEO Law Poster and Supplement at https://www1.eeoc.gov/employers/poster.cfm

Healthfirst is a provider-sponsored health insurance company that serves more than 1.2 million members in downstate New York. With more than 4,000 employees, a network of nearly 30,000 providers, and revenues in excess of $8.6 billion, Healthfirst is one of the largest health plans in the New York City area.

Our members are our North Star, and our mission is guided by their needs and preferences in ensuring a superior experience and access to the highest quality healthcare when and where they need it. Healthfirst’s commitment to quality and member satisfaction has helped us earn top ratings for HMO health plans in New York City. We know that employees shape our company and connect us to our communities, and we look to recruit and retain intelligent, driven leaders who are passionate about healthcare and embody our five culture drivers:

  • Dream Big, Plan Wisely

  • Break Down the Walls

  • Think Critically, Speak Up, Deliver with Pride

  • Inspire Through Trust, Lead By Example

  • Be Unstoppable