Job Summary

The position will be responsible for performing functions and tasks related to Provider Relations, which includes researching policies, preparing reports, assisting with provider inquires, and performing a wide variety of supporting tasks to assist the department's compliance with regulatory and operational requirements/deadlines. The incumbent will be responsible for ensuring timely follow-ups on provider relations deliverables, reviewing, and maintaining the department inbox, maintaining the Provider Relations folder, assisting with meetings, as well as work on other assigned duties.

Position Responsibilities:

• Assists with updating, maintaining, and ensuring that all provider requests via the department inbox are monitored and responded to on a timely basis.

• Manages escalated provider calls via the department phone queue on a timely basis.

• Tracks and monitors provider relations log, deadlines, and deliverables as necessary.

• Prepares and provides ad-hoc reports.

• Assists with the documentation and updates of internal workflows and desktop procedures.

• Researches issues to assist with the resolution of provider inquires and escalated member cases.

• Other projects and duties as assigned.

Possesses the Ability To:

• Triages and resolves questions to appropriate internal and external entities.

• Build working relationships with staff of all levels.

• Have strong organizational skills.

• Prioritize and organize work to meet challenging deadlines.

• Adapt to constantly changing priorities in managing various projects simultaneously.

• Maintain a high degree of credibility, confidentiality, integrity, and professionalism in a high-pace environment.

• Work independently and be highly self-motivated with minimal supervision.

• Demonstrate creativity, initiative, and good judgment while providing a high level of customer service to internal and external entities.

• Perform a wide variety of complex office support duties and set work priorities based on knowledge of various activities.

• Take direction and work as part of a team in the department, including other managers and administrative staff.

• Communicate clearly and concisely, both verbally and in writing.

• Utilize and access computer and appropriate software (e.g., Microsoft: Word, Excel, PowerPoint, Access, Visio, and SharePoint) and job-specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position.

Experience & Education:

• High school diploma or equivalent required.

• 1+ years of Administrative Assistant experience required.

Preferred Qualifications:

• Associate degree in Business Administration preferred.

Knowledge of:

• Managed Care provider and health care industry practices.

CalOptima is an equal employment opportunity employer and makes all employment decisions on the basis of merit. CalOptima wants to have qualified employees in every job position. CalOptima prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics.

If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. You can request reasonable accommodations by contacting Human Resources Disability Management at 657-900-1134.

Job Location: Orange, California

Position Type:

To apply, visit https://apptrkr.com/2334947

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