Location: Durham, NC 


Position Description

Reporting to the Director of Business Operations/Provider Relations & Support, The Provider Support Coordinator is a member of the Provider Relations & Support Team serving as an operational liaison between Medicaid and Marketplace Healthcare Providers, Carolina Complete Health (CCH), Ambetter, Centene and CCHN.   


Key Responsibilities 

Serve as the primary contact for Medicaid and Marketplace Healthcare Providers regarding operational and administrative questions and/or issues.

Serve as a liaison between the Provider, the PHP and others. 

Investigate, resolve and communicate Provider questions, issues and/or changes

Assist in educating Providers on CCH processes and operations

Coordinate and negotiate contracts 

Facilitate and provide oversight to the provider set-up and contract configuration to ensure accurate claims adjudication 

Assist in developing and maintaining the healthcare provider network plan for the awarded regions.

Assist in updating and maintaining the Provider CRM and contract database. 

Partner with the health plan contract team to ensure State compliance. 

Follow State mandated guidelines in relation to Provider Relations, Contracting and Medicaid Transformation. 

Must be available to work Monday through Friday and one Saturday per month between the hours of 9:00am - 6:00pm. 

Perform other duties as assigned 


Preferred Qualifications

High school diploma or equivalent.  

Bachelor’s degree in Healthcare Administration, Business Administration, Marketing, related field, or equivalent experience.  

Experience in Microsoft Office to include Outlook, Excel and Sharepoint

Experience in customer service, sales, provider relations, or contracting. 

Ability to handle multiple tasks at a time in a fast-paced environment

Knowledge of healthcare, managed care, Marketplace, Medicare or Medicaid insurance. 

Current state driver’s license.


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