Address
Salary- Experience in Provider Data healthcare
- Provider data entry experience
- Experience in documenting processes, creating workflows and policies
- Knowledge of compliance requirements and procedures preferred
- Critical and analytical thinking skills
- Project implementation preferred
- Experience in Facets, or similar Provider Data or claims processing system
- Experience in other provider related healthcare departments such as credentialing, provider relations or contracting preferred
- High school diploma or equivalent required.
- Two (2) years experience in health related field required.
- Experience and/or training with Health Plan Insurance Plans preferred.
- Effective written and verbal communication skills to perform group presentations, tactfully discuss issues, and listen to and understand concepts, rules and procedures. Ability to work with all levels within the organization, facilitate communication, and effectively document related activities.
- Ability to identify complex problems, review related information, employ creativity and alternative thinking to develop and evaluate options and implement solutions.
JOB SUMMARY/PURPOSE
Serves as technical advocate by assuring that providers are entered and administered properly and in a timely manner.
The ideal candidate will have the following:
DEPARTMENT DESCRIPTION
Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services’ self-funded employee health benefit plan. As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services’ mission of Building Healthier Communities Together.
EXPERIENCE/EDUCATION/QUALIFICATIONS
KNOWLEDGE/SKILLS/ABILITIES
PHYSICAL DEMANDS
Rarely
(1 - 10% of the time)
Occasionally
(11 - 33% of the time)
Frequently
(34 - 66% of the time)
Continually
(67 – 100% of the time)
CLIMB - STAIRS
LIFT (Floor to Waist: 0"-36") 0 - 20 Lbs
LIFT (Knee to chest: 24"-54") 0 – 20 Lbs
LIFT (Waist to Eye: up to 54") 0 - 20 Lbs
CARRY 1-handed, 0 - 20 pounds
BEND FORWARD at waist
KNEEL (on knees)
STAND
WALK – LEVEL SURFACE
ROTATE TRUNK Standing
REACH - Upward
PUSH (0 - 20 pounds force)
PULL (0 - 20 pounds force)
SIT
CARRY 2-handed, 0 - 20 pounds
ROTATE TRUNK Sitting
REACH - Forward
MANUAL DEXTERITY Hands/wrists
FINGER DEXTERITY
PINCH Fingers
GRASP Hand/Fist
Location: Samaritan Health Services · SHS Health Plan Ops - COO
Schedule: 1.0 (80 hrs/pp), Day
