Full Time Onsite Position
Monday - Friday
7:30am - 4:00pm
This position is responsible for all credentialing and re-credentialing audits with managed care organizations. Responsibilities include keeping current on all NCQA standards and preparing policies regarding these standards. In addition, this position is responsible for hospital credentialing for non-board approved providers.
Qualifications:Required Education: Bachelor's Degree. Ten (10) + years relevant experience and NAMSS certification (CPCS or CPMSM) may be accepted in lieu of a degree.
Preferred Education: Bachelor's in Health Care Administration, Business Administration or other related field
Necessary Skills:
1. Demonstrated use and knowledge of complex database applications.
2. Excellent written and verbal communication skills.
3. Ability to work with people across many different departments in the organization, as well as internal teams.
4. Ability to work with people of varying levels of skill sets and to utilize those skill sets.
5. Ability to interact appropriately with front-line employees, managers, directors and executives.
6. Ability to be an effective trainer.
7. Must have knowledge (or ability to comprehend) accreditation standards
Required Licensure/Certifications: Certified Provider Credentialing Specialist (CPCS) OR Certified Professional Medical Services Management (CPMSM) by the National Association of Medical Staff Services within two (2) years of date of hire or transfer into position.
Preferred Licensure/Certifications: N/A
Required Experience: 1-2 years Medical staff services/credentialing, healthcare, human resources in a healthcare environment or related field OR Crystal report writing experience.
Preferred Experience: Experience with hospital quality process improvement.