Summary:

This position reports to the Contracting Manager and is accountable for assisting the Provider Management division in its daily operations and planning specific to the administration of contracting services to MPC. The incumbent will provide the team with high-level, detail-oriented administrative assistance including document inventory, maintaining department mailboxes, managing fax receipts and distribution, completing, and uploading forms and service tickets, submitting contracts, letters, and packets, ordering supplies and other administrative duties such as serving as the initial contact for the division and composing related correspondence. The incumbent will assist the managers with coordinating internal projects and generating reports and branding.

About Maryland Care Management, Inc. (MCMI)

Maryland Care Management, Inc. (MCMI) manages Maryland Physician Care’s (MPC) statewide provider network of hospitals and physicians. Maryland Physicians Care has been providing services to the HealthChoice Medicaid populations since 1996, and we are proud of our footprint in the community. With over 230,000 members, MPC consistently has been one of MD’s largest Medicaid-managed care organizations.

Why join us?

MCMI recognizes the importance of flexibility and offers multiple work arrangements. Along with competitive pay, we offer excellent benefits (medical, dental, and vision plans, 100% employer Term Life Insurance, Short and Long-Term Disability, 401k Employer Match up to 4%) as well as 20 days of PTO, and tuition assistance/professional development plans.

Your future colleagues at MCMI are welcoming, friendly, and eager to help each other succeed. We are committed to Diversity, Equity, and Inclusion, providing organizational-wide social opportunities, and constantly improving our ongoing efforts to positively impact our members’ lives.

What You’ll Be Doing:

• Complete and upload provider credentialing forms.
• Scan and file executed contracts.
• Submit cover sheets, contracts, and attachments through our ticketing system.
• Create physical provider contract files; manage off-storage.
• Process joining participating group provider requests.
• Compose provider network declination letters utilizing appropriate template.
• Send PDF contracts for ATF sign-off and execution for contracts; send executed contracts to providers.
• Receive and distribute faxes to appropriate recipients.
• Maintain joint Outlook mailbox for Provider Relations.
• Serve as the initial contact for the division.

Secondary Functions:

• Maintains effective working relationships with various providers, networks, and managed healthcare components.
• Continues education regarding change and trends in health care management and specific provider communications.

Knowledge and Skills:

• Work requires demonstrated experience with Microsoft Office 365 to include proficient and successful utilization of Word, Excel, Outlook, Teams, and Adobe applications.
• Work requires strong problem-solving and the ability to use reason to define problems, collect data, establish facts, draw valid conclusions, and design, implement, and manage appropriate action plans.
• Work requires excellent interpersonal skills to effectively interface with all levels of staff, providers, vendors, and business-related associates.

Education and Work Experience:

• High School diploma or GED.
• 3 years of customer service experience within a healthcare environment
• 1 year of provider/claims experience (preferred).

EEOC Statement: 

Following applicable federal, state, and local laws, MCMI prohibits discrimination in employment based on race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age, disability, genetic information, or any other characteristic protected by law. This commitment extends to all aspects of employment, including hiring, promotion, compensation, benefits, training, social and recreational programs, and all other conditions and privileges of employment.

As a healthcare organization, we recognize the vital importance of inclusivity in delivering quality care to our patients. We strive to foster an environment where individuals of all backgrounds feel respected, valued, and supported. We aim to better comprehend the unique needs of our patients and provide healthcare services that are culturally competent and sensitive.

We encourage candidates from all backgrounds to apply and join us in our mission to provide compassionate and inclusive healthcare. We believe that a diverse workforce enriches our organization and allows us to better understand, connect with, and serve our diverse patient population.