Covenant HealthCare · 10 hours ago
NETWORK DEVELOPMENT ADMINISTRATOR
Saginaw, MI
Full-time
Onsite
Mid LevelCovenant HealthCare is committed to providing extraordinary care for every generation. The Network Development Administrator is responsible for ensuring accurate data collection and maintenance for all providers within the organization, as well as overseeing provider rosters and auditing credentialing information.
Health CareHospitalMedical
Responsibilities
Responsible for oversight of CHP provider rosters, both internal and external
Maintains provider database continuously and consistently to ensure that accurate and current information is available to all stakeholders
Audit, assess, implement, effectively utilize, and maintain provider database processes and information systems
Establish working relationships with providers, office managers, professional billing, and payer contacts
Recognize potential discrepancies and adverse information, and independently investigate and validate information in the provider database
Ensure discrepancies are addressed promptly and the proper follow-ups are completed in a timely manner
Serve as main point of contact for external queries regarding CHP provider roster and provider data
Facilitate meetings with leadership to develop provider on-boarding processes to assist in providing the most current and accurate data available
Organize information and data to identify/explain trends, problems, and their causes
Compare, contrast, and combine data to determine underlying issues
Identify associations between seemingly independent problems or events to recognize trends, problems, and possible cause-effect relationships
Securely manage information as the single source of truth by effectively navigating database software and maintaining data integrity
Evaluate, analyze, and recommend software upgrades, changes, interfaces, and modules
Evaluate the adequacy of the provider network to identify gaps in covered specialties and make recommendations to CHP leadership to help grow the provider network
Serve as a staff member on the Mosaic ACO Membership Committee
Maintain the Physician Group Incentive Program (PGIP) Practitioner Alignment (PA) Tool ensuring that PGIP rosters are current, and the data submitted in snapshots to BlueCross are timely and accurate
Work with payer partners on annual audits regarding provider data integrity and attestations
Work with CHP credentialing staff, Covenant HealthCare’s Central Billing Office and Medical Staff Office to ensure provider additions, deletions, and changes are shared and reconciled and that any updates are properly reflected in CHP rosters and credentialing software
Other duties as assigned
Qualification
Required
Bachelor's Degree in health services administration or Business required
Knowledge of the Council for Affordable Quality Healthcare (CAQH) reporting requirements and CAQH software
Experience with electronic credentialing software: MD Staff or other credentialing software
Excellent computer knowledge and capability to use computer programs as required, i.e., Microsoft Word, Excel
Achieve the process of change by recognizing and communicating the need
Detailed and accurate data input into MD Staff or other credentialing software as outlined in policy
Express thoughts clearly, concisely, and effectively both verbally and in writing
Ability to communicate upward, downward and across the organization
Encourage the open expression of ideas and opinions of others
Ability to adapt behavior in response to new information or changing circumstances
Open to change and new information, ideas, methods, or approaches
Work and collaborate effectively with others in unstructured or dynamic environments and adjust the original objective or plan to allow for the best possible results
Understand information technology concepts, key functions, terminology, and work products; effectively utilizes information technology, MD Staff
Knowledge of CAQH and NCAQ
Understand legal concepts, key functions, terminology and the roles and responsibilities of legal counsel
Understand current performance improvement concepts and ideas, such as setting goals, implementing systemic changes, measuring outcomes, and optimizing resources to meet the needs of the organization
Exhibit confidence and professional diplomacy while identifying, organizing, facilitating and/or sustaining mutual beneficial partnerships with people of all levels internally as well as externally
Present in a confident, clear, and enthusiastic manner when addressing people in a small or large group
Demonstrate a sound knowledge of the subject matter
Effectively use various audio-visual media for presentations
Inspire trust and confidence among stakeholders through reliability, authenticity, and accountability
Displays a credible presence and positive image when representing the organization
Organize work, set priorities, and determine short- or long-term goals, and strategies to achieve them
Commit to continuous performance and process improvement
Establish productive, cooperative relationships with peers, management, and stakeholders both internal and external to the organization
Encourage and facilitate cooperation, trust, and group identity; and build commitment, team spirit, and strong relationships
Computer and word processing ability including MD Staff, Microsoft Word, and Excel
Typing, ability to communicate well with others, proficiency in listening, writing, and speaking
Excellent written communication skills for constructing minutes and correspondence, and excellent verbal skills for communicating individually and in group meetings
Strong interpersonal, diplomatic, and organizational skills
Demonstrates ability to maintain information in a confidential manner
Customer Service focused on all daily activities
Demonstrates ability to make sound independent decisions within boundaries of policies and procedures
Ability to maintain regular, punctual attendance consistent with the ADA, FMLA and other federal, state and local standards
Constant sitting
Frequent carrying, handling, tasting, and smelling
Frequent lifting 11-25 lbs
Occasional lifting 26-50 lbs
Occasional standing, walking, talking and hearing, pushing, pulling, stooping, kneeling, and squatting
Constant near vision, far vision, depth perception, color vision and field of vision
Preferred
Experience as a participant in continuous process improvement preferred
Company
Covenant HealthCare
Covenant HealthCare is a group of six private acute medical hospitals.
Founded in 1997
1001-5000 employees
H1B Sponsorship
Covenant HealthCare has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (20)
2024 (13)
2023 (19)
2022 (24)
2021 (11)
2020 (17)
Funding
Current Stage
Late StageTotal Funding
unknown2002-01-01Acquired
Leadership Team
Beth Charlton
Vice President Patient Services and Chief Nursing Officer
Recent News
Company data provided by crunchbase