AIDS Healthcare Foundation

Provider Relations Data Coordinator

US-FL-Ft. Lauderdale
Req No
Managed Care
Regular Full-Time



Does the idea of doing something that really makes a difference in people’s lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees?

If so, Positive Healthcare at the AIDS Healthcare Foundation is the place for you!


Positive Healthcare, AIDS Healthcare Foundation's Managed Care Division, has provided people living with HIV quality health care since 1995 when it started the nation’s first Medicaid health plan for HIV-positive people living in Los Angeles. Today, Positive Healthcare cares for more than 7,000 lives in California and Florida.



PHP is a Medicare Advantage Prescription Drug health plan specifically for Medicare beneficiaries who are living with HIV and reside in Duval, Broward and Miami-Dade Counties.

PHP is the first HIV-specific special needs health plan approved by the Centers for Medicare & Medicaid Services (CMS). This plan covers routine doctor and specialist office visits, emergency and urgent care, hospitalization, and more. It also includes a prescription drug benefit for no monthly premium.


PHC Florida

PHC Florida is a Medicaid managed care plan designed specifically for HIV-positive individuals who are eligible for Medicaid and live in Broward, Miami-Dade and Monroe Counties.  PHC Florida is a Managed Medical Assitance (MMA) plan offered through Florida’s statewide Medicaid Managed Care Program.

AHF’s core values are:

• Patient-Centered
• Value Employees
• Respect for Diversity
• Nimble
• Fight for What’s Right

STILL INTERESTED? Please continue!


The Provider Relations Coordinator is responsible for projecting and integrating the Mission and Core Values of the organization within and outside of the Managed Care Department.

Essential Duties & Responsibilities
Includes the following.  Other duties may be assigned.

  • Support efforts of Provider Relations and Credentialing in ensuring accurate and complete provider demographics, including all information needed for the acceptance of encounters, provider network files, and enrollment files by CMS and DMHC.
  • Responsible for entering initial credentialing, demographic and contract information in PHP/PHC MIS system for newly contracted providers, delegated provider groups and non-contracted providers.
  • Responsible for accuracy and completeness of provider information in PHP/PHC MIS system by tracking terminations and additions to provider network and remediating or completing any information needed not included on files supplied by various PHP/PHC network affiliates.
  • Responsible for contacting network providers and updating demographic information in the MIS system on a regular basis and analyzing exception reports when provider information included on submitted files and information resident in MIS system conflicts.
  • Responsible for working with Provider Relations Department on cataloguing and updating contract files.
  • Responsible for working with Provider Relations and MIS Departments on submission compliance of required regulatory and other regularly scheduled network reports, including provider terminations and additions, and provider directories.
  • Responsible for generating ad-hoc provider reports, LOA’s, and Provider Agreements.
  • Responsible for maintaining 3rd Party Contracting grid and will act as a liaison to 3rd party vendors.
  • Responsible for working with MIS departments on monthly update of provider network files on websites in compliance with CMS and AHCA.
  • Responsible for distributing various notices of provider network changes to appropriate departments and providers.
  • Responsible for auditing the Provider Directories on a monthly/quarterly basis.
  • Responsible for logging Provider Grievances and generating acknowledgement and resolution letters to providers.
  • Responsible for maintaining current provider files, including incoming/outgoing correspondence.

Supervisory Responsibilities
This job has no supervisory responsibilities.


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