PROVIDER NETWORK COORDINATOR - PACE

Job Description

Job Purpose

The Provider Network Coordinator is responsible for the development, coordination, and maintenance of the provider network for the Program of All-Inclusive Care for the Elderly (PACE). This role focuses on cultivating strong relationships with providers, ensuring network adequacy, supporting the credentialing process in collaboration with the Credentialing Coordinator, and providing orientation and ongoing engagement for network providers. The Coordinator plays a vital role in ensuring the provider network delivers high-quality, person-centered care to meet the unique needs of PACE participants.

Duties and Responsibilities

Provider Network Development

Identify, recruit, and contract with qualified providers to support the clinical and non-clinical service needs of the PACE program.

Develop and implement strategies to expand and maintain an adequate and diverse provider network in accordance with regulatory requirements and participant needs.

Assess geographic and specialty gaps and work proactively to address deficiencies in the network.

Relationship Management

Serve as the primary liaison between PACE and its provider network.

Build and sustain positive, collaborative relationships with contracted providers, ensuring high levels of provider satisfaction.

Conduct regular outreach and check-ins with providers to address concerns, share updates, and promote partnership.

Lead and coordinate provider orientations to familiarize new providers with PACE program values, processes, and participant care expectations.

Credentialing and Onboarding

Collaborate closely with the Credentialing Coordinator to ensure timely and accurate credentialing and re-credentialing of all network providers.

Track the credentialing process to ensure compliance with internal policies and regulatory requirements.

Coordinate onboarding processes, including documentation collection, training schedules, and communication flow for newly contracted providers.

Communication & Reporting

Maintain accurate and up-to-date provider database and documentation.

Generate and distribute provider directories, reports, and network updates as needed.

Collect and analyze provider feedback to support continuous improvement efforts.

Compliance & Quality Assurance

Ensure that all provider network activities comply with federal and state regulations, including CMS, DHCS, and PACE-specific guidelines.

Support audit and compliance initiatives related to provider contracting and network adequacy.

All other duties as assigned.

Qualifications

Education and Experience:

Bachelor’s degree in healthcare administration, business, public health, or related field required; equivalent work experience may be considered.

3+ years of experience in provider network management, contracting, or healthcare administration, preferably within managed care, PACE, or long-term services and supports.

Experience working with credentialing processes and regulatory compliance strongly preferred.

Skills and Competencies:

Strong interpersonal and relationship-building skills.

Excellent written and verbal communication.

Knowledge of provider contracting principles and healthcare delivery systems.

Ability to multitask, prioritize effectively, and manage multiple relationships.

High attention to detail and strong organizational skills.

Proficient in Microsoft Office and provider management systems (e.g., credentialing software, EMR systems).

Physical Demands

Must be able to remain in a stationary position 50% of the time.

Ability to occasionally move about inside the office to access file cabinets, office machinery, etc.

Able to operate a computer and other office productivity machinery, such as a calculator, copy machine, and computer printer.

Able to constantly position yourself to maintain files in file cabinets such as reaching with hands and arms, kneeling, crouching, etc.

The ability to communicate, detect, converse with, discern, convey, express oneself, and exchange information is crucial for this role.

Full-time