Job Title: Network Management In-House Coordinator
Department: Network Management
Job Reports To: Manager of Network Management
Primary focus of this role is to telephonically assist providers with issues/concerns and education on
AppleCare Medical Groups Policies and Procedures. Individual is responsible for being a resource for
Network Managers and all other team members. Individual must be highly motivated as well as multitasked.
The individual must be able to establish a rapport and interact well with all departments levels while maintaining a
professional image and attitude.
RESPONSIBILITIES AND FUNCTIONS
o Acts as a liaison between AppleCare Medical Group and Providers, providing resolution to
provider questions, concerns, issues, and grievances by way of education on AppleCare
Medical Groups Policies and Procedures
o Establish/maintain collaborative relationships with providers, Customer Relations team, and
o Participate in managing Network Management Department incoming/outgoing calls
o Assist Providers via telephone in areas including claims, eligibility, and referrals etc.
o Return telephone calls and e-mails within twenty-four (24) hours to ensure that professional
and business relationships are maintained
o Document all telephone calls, correspondence, etc. from Providers in our Quickbase
o Identify and communicate complex/critical issues through appropriate channels; supporting
the AppleCare Medical Group model for resolution
o Provide input and suggestions to Supervisor on goal/objectives; process improvements,
o Promote and provide telephonic trainings on AppleCare Medical Group electronic systems,
Cerecons, Office Ally, Care 360, AppleCare HCC on-line and other systems as needed
o Participate in Network Management Department projects
o Provide assistance to interoffice departments including provider communication, education,
o Develop working relationships with Network Managers to ensure timely resolution to
Work with Network team to prepare for the annual office manager and physician meetings.
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Perform other duties as assigned
Level of Education:
Bachelor's Degree preferred or equivalent experience
Professional Certification or License
Valid California Driver license and insurance.
Level of Experience
Preferred minimum 1-2 years of IPA/HMO setting or equivalent experience in managed care
Specific Knowledge, Skills, and Abilities
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The
requirements listed below are representative of the knowledge, skill and/or ability required. Exceptional
customer service and conflict resolution skills
Excellent written/verbal communication skills
Excellent time management and organization skills
Must be able to work with only minimal supervision
Ability to make decisions in the absence of detailed instructions
Be able to work both independently and in a team environment
Must be proficient in Microsoft Office navigation, Access, Excel, and Word
Ability to speak, read, and write English proficiently. Ability to effectively present information and
respond to questions from managers, employees, and providers. Bi-lingual a plus.
Physical Demands The 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. In table below show the
minimal physical and weight requirements for this position by checking the appropriate boxes.
NONE OCCASIONALLY FREQUENTLY CONSTANTLY
Use hands to finger, handle, or feel X
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Reach with hands and arms X
Climb or balance X
NONE OCCASIONALLY FREQUENTLY CONSTANTLY
Stoop, kneel, crouch, or crawl X
Talk or hear X
Taste or smell X
Travel (local only) X
Weight Lifted or Force Exerted?
Up to 10 pounds X
Up to 25 pounds X
Up to 50 pounds X
Up to 100 pounds X
More than 100 pounds X
Normal office environment. May be subject to temperature variations in the office.
Occasional early morning, evening or weekend work. Occasional pressure due to
multiple tasks, deadlines, calls or interruptions.
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