Intl Network Develop Coord II

Location:

Calmont Operations Building

Department:

Network Mgmt

Shift:

First Shift (United States of America)

Standard Weekly Hours:

40

Summary:

Responsible for maintaining all provider data maintained within CCHPs provider databases. Processes all requests for changes to the provider databases in accordance with departmental policies and procedures. Responsible for development and production of standard and ad hoc reports which is required for routine operations or special projects. Trains other CCHP staff members to generate standard reports from the database as required. Responsible for establishing mechanisms to enhance the existing database applications as needed to improve the quality of data available to health plan staff. Assists with Single Case Agreement information and various provider participation inquires. Assistance with claims payment inquiries. Assists with incoming communication to the Network Development department, and performs general duties to support CCHP operations.

Additional Information:

Responsible for maintaining all provider data maintained within CCHPs provider databases. Processes all requests for changes to the provider databases in accordance with departmental policies and procedures. Responsible for development and production of standard and ad hoc reports which is required for routine operations or special projects. Trains other CCHP staff members to generate standard reports from the database as required. Responsible for establishing mechanisms to enhance the existing database applications as needed to improve the quality of data available to health plan staff. Assists with Single Case Agreement information and various provider participation inquires. Assistance with claims payment inquiries. Assists with incoming communication to the Network Development department and performs general duties to support CCHP operations.

Education & Experience:

• Associate degree preferred but not required
• Five (5) experience working with database applications such as Access, word processing, spreadsheet and graphic presentation applications
• Superior Access database, Microsoft Word, and Excel skills
• Three (3) years of claims experience including both paper and electronic claim submissions
• Good oral and written communication skills
• Strict attention to detail, including analysis, documentation, oral presentations, general organization and specific organization of personal work duties
• Willingness to continuously improve skills in database and related applications
• Willingness to continuously improve knowledge base in both health care and provider contracting and management

Certification/Licensure:

N/A

About Us:

Cook Children's Health Plan

Cook Children's Health Plan provides vital coverage to nearly 120,000 people in low-income families who qualify for government-sponsored programs in our six county service region.  Cook Children's Health Plan provides health coverage for CHIP, CHIP Perinatal, STAR (Medicaid) and STAR Kids Members in the Tarrant county service area. The counties we serve includes Tarrant, Johnson, Denton, Parker, Hood and Wise.

Cook Children’s is an equal opportunity employer. As such, Cook Children’s offers equal employment opportunities without regard to race, color, religion, sex, age, national origin, physical or mental disability, pregnancy, protected veteran status, genetic information, or any other protected class in accordance with applicable federal laws. These opportunities include terms, conditions and privileges of employment, including but not limited to hiring, job placement, training, compensation, discipline, advancement and termination.