Administrative Coordinator - Provider Network Management

<p><strong>By joining Region 10, you can help actualize our mission of promoting opportunities for recovery, discovery, health and independence for individuals receiving services through ease of access, high quality of care and best value.&nbsp; View the details below on how you can become an Administrative Coordinator for Region 10 PIHP</strong></p>

Port Huron, MI

Region 10 PIHP

<p>Region 10 Prepaid Inpatient Health Plan Provides public services for mental health and substance use disorders through the Community Mental Health agencies in Genesee, Lapeer, Sanilac and St. Clair counties and a panel of other care providers.</p> <h4>Mission: Promoting opportunities for Recovery, Discovery, Health and Independence for individuals receiving services through ease of access, high quality of care and best value.</h4>

keywords: teamwork,network,provide,management,compliance,support,reporting,minimum qualifications,ability,develop and/or maintain,preferred qualifications


Overview: <p>An employee at this level is required to perform some or all of the following duties, which do not include all tasks to be performed</p> <ul> <li>Coordination of designated Provider Network Management projects or tasks</li> <li>Provide training to staff and contract agencies</li> <li>Participate in and / or provide support to PIHP Provider Network Committees and Workgroups</li> <li>Participate in Statewide Reciprocity efforts</li> </ul>
Responsibilities: <ul> <li>Coordinate Procurement Activities</li> <li>Conduct Pre-Delegation Assessments</li> <li>Lead on Managed Care Delegated Functions</li> <li>Contract Monitoring support and Subject Matter Expert</li> <li>Manage Reviews of Medicaid Bulletins and Proposed Policies</li> <li>Manage PIHP and Provider Network Directories</li> <li>Monitoring Network Adequacy Standards Performance</li> <li>Policy and Procedure Review</li> <li>Report Development</li> <li>Provider Manual Development</li> <li>Gap Analysis Development</li> <li>Provide clarification on contract requirements and standards</li> <li>Provide support for external site reviews</li> <li>Other tasks as assigned</li> </ul>
Requirements: <strong>Minimum Qualifications:&nbsp;</strong><em>(An employee must have the following credentials, training, and experience.)</em><br /> <ul> <li>Bachelor&rsquo;s Degree in behavioral health field</li> <li>Experience in the area of Contract or Provider Network Management</li> <li>Experience in writing reports, analyzing data and administrative projects</li> <li>Ability to be a &ldquo;work leader&rdquo; (of a person or function), or advise others</li> <li>Experience in managing projects and teams</li> <li>Advanced knowledge of Microsoft Word and Excel</li> <li>Basic knowledge of Microsoft PowerPoint</li> <li>Ability to exercise some flexibility in problem solving, when expected results are clear and generally set by others, provided certain outcomes are avoided</li> <li>Ingenuity is required to adapt, alter or improvise alternatives when unexpected situations occur</li> <li>Ability to exercise discretion and some flexibility in selecting an optimal solution from established alternatives to obtain the desired outcome</li> <li>Ability to use or exert influence in a work process</li> <li>Ability to provide, exchange or explain information which conveys an opinion or evaluation of the facts or analyses</li> <li>Ability to develop and/or maintain effective work relationships with new, established or non-receptive individuals/organizations through tact, diplomacy and persuasion</li> <li>Valid State of Michigan Driver&rsquo;s License</li> <li>Must have access to transportation</li> </ul> <br /><strong>Preferred Qualifications</strong><br /> <ul> <li>Master&rsquo;s Degree in behavioral health field</li> <li>Experience working at Pre-Paid Inpatient Health Plan (PIHP) and / or Community Mental Health (CMH)</li> <li>Experience working at Substance Use Disorder Service Provider and / or CMH subcontract Provider)</li> <li>Basic knowledge of MDHHS reporting</li> </ul>