Campus Pride Jobs

Working Each Day to Make a Difference

At Community Health Plan of Washington, we're driven by our belief that everyone deserves access to quality health care.

More than 25 years ago, we made a commitment to improve the health of our communities by making quality health care accessible to all Washington state residents.

We continue that pledge today by providing affordable comprehensive coverage to more than 315,000 individuals and families throughout the state.

• We are a local not-for-profit health plan in Washington State.
• We are committed to keeping Washington families healthy.
• We connect our communities to the health resources they need.
• We provide access to high-quality care for our members.
• We connect and empower our members through technology.
• The Community Health Centers we partner with strive to support members with a comprehensive mix of medical resources in one convenient location.
• Our partnerships with Community Health Centers and our extended provider network help us improve the health care delivery system.

To learn more about how you can make a difference working at Community Health Plan of Washington, visitwww.chpw.org{rel="nofollow"}.

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Provider Relations Coordinator -- Hybrid, WA

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[POSITION PURPOSE:]{.underline}

The Provider Relations Coordinator (PRC) provides support to the Provider Relations Department to ensure Community Health Plan of WA meets regulatory requirements and other administrative tasks. The PRC will assume the duty of operational support to optimize workflow procedures for the department.* *

[PRINCIPAL DUTIES:]{.underline}

• Conduct and track annual provider appointment and after-hours access reviews.
• Monitor, track, collect and file Behavioral Health invoices/encounters and conduct provider outreach to collect missing and/or inaccurate invoices/encounters.
• Monitor and track completion of provider mandatory trainings (i.e., Access, Orientation, SNP-MOC) and maintain provider training attestations. Conduct provider outreach as needed to ensure mandatory provider trainings are completed.
• Monitor and respond to external/internal inquiries via Provider Relations inbox and/or through other sources.
• Maintain and update key provider contacts in OnBase and/or other applicable systems.
• Generate and maintain provider contact lists for provider communications, i.e., annual Provider Surveys, SNP MOC, Workshops.
• Assist with the processes relevant to BH invoice rate increases and WISe regulatory reporting.
• Assist in compiling and organizing monthly provider and member complaints in preparation for analysis.
• Key participant in the Provider Communication Workgroup.
• Assist with tasks relevant to the Annual Provider Workshops and Joint MCO Provider Trainings.
• Other duties as assigned. Essential functions listed are not necessarily exhaustive and may be revised by the employer, at its sole discretion.

[QUALIFICATIONS:]{.underline}

[Education]{.underline} & [Prior Related Experience]{.underline}:

Have minimum of two (2) years in an administrative setting required, preferably in the Health Care Industry or in a Managed Care Organization.

Have experience in project coordination, showcasing the ability to plan, organize, and execute tasks efficiently to support the teams in various initiatives, including internal and external meetings, training programs, and compliance activities.

Have experience and familiarity with at-risk populations, communities of color and l