Provider Relations Coordinator-Hybrid remote

Description

Who We Are

Innovative Integrated Health (IIH) is a mission-driven healthcare organization dedicated to helping frail, underserved, and multiethnic seniors live safely and independently at home with dignity. Through the Program of All-Inclusive Care for the Elderly (PACE) model of care, we deliver high-quality, personalized healthcare and supportive services that improve quality of life across the communities we serve.

At IIH, our work is rooted in compassion, cultural understanding, and deep respect for those in our care. Team members play a vital role in supporting seniors throughout Central and Southern California—delivering care that’s not only clinically excellent, but also personal, coordinated, and community-based.

When you join IIH, you become part of a team committed to making a real difference in the lives of older adults—every single day.

Benefits

• 401(k) 
• Dental insurance
• Employee assistance program
• Employee discount
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid sick time
• Paid time off
• Referral program
• Retirement plan
• Vision insurance

Job Summary

The Provider Relations Coordinator is responsible for coordinating and maintaining service relationships with Innovative Integrated Health (IIH) providers including physicians, hospitals, ancillary service providers and long-term care facilities. Responds to electronic and direct inquiries from providers about policies, claims, patient referrals, authorizations, and credentialing. The Provider Relations Coordinator will provide support to the Provider Relations Administrators on projects such as provider outreach and engagement, provider office roster updates, and provider training initiatives. The Provider Relations Coordinator oversees the credentialing and re-credentialing process by gathering all necessary and required documentation while ensuring timely completion. This role also maintains accurate and current provider information within relevant data systems.

Essential Job Functions

Duties include, but are not limited to:

• Initiating and maintaining effective channels of communication with provider offices.
• Gathering, verifying and updating all pertinent information relating to participating healthcare providers.
• Establishing and maintaining relationships with healthcare providers through e-mail and telephone outreach, prompt resolution of issues, and excellent customer service.
• Performing intake of specialty providers and responding to inquiries related to credentialing, claims, demographics, letters of agreement, contracting, etc., as needed.
• Handling and responding to requests and queries for both internal and external entities related to provider information, as necessary.
• Answering questions from provider offices related to prior authorization requests, claims processing, and the provider portal
• Support changing management efforts and promote a culture of collaboration and continuous improvement.
• Assisting Provider Relations Administrators and working with provider offices to complete contracts and letters of agreement or assist with more complicated authorization queries received.
• Conducting training on IIH policies, procedures and services with provider offices.
• Maintaining a working knowledge of all applicable federal, state, and local laws and regulations regarding healthcare.
• Attend and participate in staff meetings, in-services, projects, and committees as assigned.
• Adhere to and support the center’s practices, procedures, and policies including assigned break times and attendance.
• Accept assigned duties in a cooperative manner; and perform all other related duties as assigned.
• May require use of personal vehicle, if applicable. If using a personal vehicle, a valid California Driver’s License, current proof of insurance, and vehicle registration are required.

Knowledge, Skills, and Abilities

• Proficient knowledge of computer skills. MS Office (Word, Excel, Access, PowerPoint, and Outlook).
• Knowledge of general office procedures, equipment and filing systems.
• Ability to communicate effectively, both orally and in writing.
• Ability to quickly learn department policies, procedures, goals, and services.
• Skill: Attention to detail and accuracy.
• Ability to change priorities regularly.

Working Conditions and Physical Demands

The working conditions and physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Ability to access all areas of the center throughout the workday.
• Ability to lift a minimum of 35 pounds occasionally, 15 pounds frequently, and 7 pounds constantly; required to obtain assistance of another qualified employee when attempting to lift or transfer objects over 50 pounds.
• Requires constant hand grasp and finger dexterity; frequent sitting, standing, walking and repetitive leg and arm movements, occasional bending, reaching forward and overhead; squatting and kneeling.
• Work is generally performed in an indoor, well-lighted, well-ventilated, heated, and air- conditioned environment.

Requirements

Experience

• Minimum of one (1) year of demonstrated experience in the healthcare field, preferably in a provider relations or provider network support role.
• Managed care experience preferred.
• Minimum of one (1) year of documented experience working with a frail or elderly population.

Education and Qualifications:

• High School diploma or equivalent required
• Bachelor’s degree preferred.
• Valid CA Driver’s License

Core Values

• Respect at the core of our interactions.
• Honesty and Integrity with every endeavor
• Patient – Centered care aligned with participant values, beliefs, and preferences.
• Encouragement that motivates and empowers others to be the best they can be.
• Quality Care that is efficient, transformative and innovative.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.