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Provider Support Coordinator (Orange County)
Provider Support Coordinator (Orange County)Astiva Health, Inc • Orange County, CA, United States
Provider Support Coordinator (Orange County)

Provider Support Coordinator (Orange County)

Astiva Health, Inc • Orange County, CA, United States
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  • [job_card.full_time]
[job_card.job_description]

Join Astiva Health Where Compassion Meets Innovation

At Astiva Health, we believe healthcare should be accessible, affordable, and deeply personal. Based in Orange, CA, we serve a diverse community through Medicare and HMO services designed to meet people where they are. Were not just building networks, were building trust, equity, and better outcomes. If youre ready to help reshape healthcare delivery with purpose and precision, we invite you to bring your talents to our team.

What Youll Do

The Provider Support Coordinator (PSC) is entrusted with delivering exceptional service to Independent Practice Associations (IPAs), Medical Groups, Management Services Organizations (MSOs), providers, hospitals, and ancillary network providers. The PSC plays a vital role in the recommendation, development, and execution of Quality-of-Service strategies designed to enhance operational effectiveness and elevate provider satisfaction levels.

Why Astiva?

Were more than a health planwere a movement toward better care. At Astiva, youll find a culture of collaboration, innovation, and heart. We celebrate diversity, empower our teams, and invest in the communities we serve. Come build something meaningful with us.

Your Impact and Core Responsibilities

Relationship Management : Foster strong, collaborative relationships with contracted Providers to ensure seamless communication and partnership.

Issue Resolution : Coordinate between Providers and internal teams to quickly resolve questions about eligibility, benefits, contracts, claims, and referrals via phone, voicemail, and email.

Data Accuracy : Conduct outreach to verify Provider information, ensuring the accuracy of the provider directory and compliance with regulatory requirements.

Portal Support & Training : Assist Providers with portal account setup and deliver virtual training to enhance their ability to navigate and utilize the system efficiently.

Credentialing Support : Partner with the Credentialing team to collect necessary documentation from Providers, supporting timely onboarding and compliance.

Quality Improvement Collaboration : Support HEDIS and RAF initiatives by obtaining medical records, contributing to the organizations quality performance metrics.

Provider Education : Coordinate and facilitate Provider meetings focused on education and initiatives such as annual wellness exams.

Policy Adherence : Maintain up-to-date knowledge of departmental policies, procedures, and programs to ensure consistent and compliant operations.

Flexibility : Perform additional duties as needed to support departmental goals and organizational success.

Enhances Provider satisfaction and engagement through responsive and proactive support.

Improves operational efficiency by resolving Provider issues quickly and accurately.

Supports compliance and data integrity through diligent verification and documentation.

Contributes to quality care outcomes by facilitating Provider participation in key health initiatives.

Strengthens the organizations reputation and performance through effective provider relations and collaboration.

What You Bring

Education & Experience

Bachelors degree in Business, Healthcare Administration, Finance, or equivalent experience

1 year previous experience in a provider relations role within a health plan, IPA, or medical group strongly desired. Skills & Competencies

Strong working knowledge of Medicare, Medicaid and HMO health plan required.

Strong critical thinking and independent research skills for complex issues. Practical problem-solving skills and a collaborative mindset

Self-motivated with a positive attitude and customer service orientation

Strong written and verbal communication skills

Fluent in Vietnamese, Korean, Spanish, or Chinese. Preferred

Benefits That Support You

401(k) Retirement plan

Health, Dental, and Vision Insurance

Health savings account

Life insurance

Paid time off and Holidays

Referral program

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