Company Statement

For the last 80 years, EmblemHealth has been taking care of New York’s heart and soul, its people. Today, health care is more complex than ever. That’s why we’re at the forefront of change. We work alongside our customers to offer access to high-quality, affordable care, help navigate the health care experience, and make good health achievable; because everyone deserves to be taken care of. We deliver on our mission every day by living our values with our colleagues, members, clients and partners. It begins with caring and respecting all those we work with. We believe a culture of diversity and inclusion is vital to serve our unique and diverse customers. We seek for continues improvement and innovation and believe being agile and nimble is our advantage. We bring a strong sense of partnership to every relationship – internally and externally. The EmblemHealth family of companies offers competitive health, welfare, and retirement benefits as well as incentive pay plans and more.

Network Project Coordinator

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Manager & Professional
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200CT Requisition #
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The primary function of the Network Project Coordinator is to provide support to the Provider Network Management team and assist with tasks as needed to support that the department is managing Provider relationships and Network initiatives.  Support functions such as tracking information, assisting with issue resolution, and reporting of payments and other contractual trend information.  Work on various individual Network Management projects and initiatives to support department leadership.

Responsibilities:
  • Review and support project follow through for relationships with large health systems, including all processes of analyzing financial, quality, and claims data into spreadsheets and/or database with accuracy and thoroughness to yield the highest results.
  • Support the development and submission of forms and reports to aid in the completion of contracting and relationship management.
  • Work closely with operational areas such as UM, Claims and GAD to ensure compliance with facility agreements.
  • Maintain, update databases used to track and report on key contract terms, payment drivers and disputes.
  • Perform other duties, projects and cross coverage as assigned by Provider Network leadership.
Qualifications:
  • Bachelor’s Degree
  • 2-3 years of experience in the healthcare or managed care industry, or related field required with some experience in claims payment and coding methods, contracting, project and/or relationship management required
  • 2-3 years of experience in a managed care environment preferred
  • Proficient in Microsoft Office (Word, PowerPoint, Excel, Access) required

EEOC Statement

We are committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our people and our business. We are an equal opportunity/affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law.

Sponsorship Statement

Depending on factors such as business unit requirements, the nature of the position, cost and applicable laws and regulations, EmblemHealth may provide work visa sponsorship for certain positions.

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