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A Family Health Center is an NCQA recognized Patient Centered Medical Home (PCMH) Level 3. Also, completion of internal credentialing which includes BCLS, Infection Control, and Child Abuse Training.
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Maintains knowledge of current payor, agency, and third-party requirements for credentialing providers, including, but not limited to, NCQA, URAC, and CMS standards. Reviews credentialing and recredentialing files to ensure that they meet NCQA, URAC, and CMS standards, and payor and company requirements.
Full-timeExpandApply NowActive JobUpdated 15 days ago - UpvoteDownvoteShare Job
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Additional responsibility is to monitor reappointments to assure none go over 24 months, per TJC standards and/or 36 months, per NCQA standards. Must have working knowledge of Medical Staff Credentialing concepts and comprehensive knowledge base of state/federal regulatory requirements and accreditation standards related to the organized medical staff.
Full-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Familiarity with NCQA and JC standards; Medical Staff Bylaws, Rules and Regulations and hospital policies, as they relate to credentialing. ยท Maintains communication with Credentialing Manager regarding credentialing issues.
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Confirm delegated provider credentialing audits performed by the delegated credentialing team for initial, annual, and interim assessments in accordance with Joint Commission, NCQA, CMS, state and federal requirements.
Full-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Maintains correspondence files and credentialing archival files. Knowledge of NCQA and/or JCAHO Accreditation standards. Maintains and updates credentialing database, inclusive of demographic and licensure information.
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Performs other credentialing duties as requested. One year Credentialing experience preferred. Maintains and updates continuing medical education/ACLS credits and other training requirements.
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Licensure, Certification & Registration:Certified Professional in Medical Staff Management (CPMSM)ORCertified Provider Credentialing Specialist (CPCS) preferredORAchievement of certification (CPMSM/CPCS) within 24 months of becoming eligible.
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Skilled in computer applications including MS Word, MS Excel, database administration and scanning applications. US Anesthesia Partners, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, gender identity, sexual orientation, pregnancy, status as a parent, national origin, age, disability (physical or mental), family medical history or genetic information, political affiliation, military service, or other non-merit based factors.
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Must possess sufficient eye-hand coordination/manual dexterity to operate a keyboard, photocopier, telephone, calculator and other office equipment. Processes initial applications and reappointments for hospitals, surgical centers and managed care entities for assigned divisions.
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Involves frequent contact with professional staff and managed care organizations. AS or B.S. degree in business administration or health care related field is a plus. Knowledgeable in Federal and State Regulation on Confidentiality; and Peer Review Guidelines.
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In depth knowledge of credentialing + NCQA Standards. Supervised the coordination of provider enrollment activities (including initial credentialing or re-credentialing) for all providers.
Full-timeExpandApply NowActive JobUpdated 12 days ago - UpvoteDownvoteShare Job
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Processes providers applications for privileges and reappointments and monitors licensure renewal activity for Physicians, CRNAs, APNs, and PAs. disclaimer: The above job description has been written to indicate the general nature and level of work performed by employees within this classification.
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Credentialing Manager - IntraCare - Carrollton, TX. Research credentials in alignment with NCQA and national health plan standards as requested by HR and others to support primary source verifications need as they arise, especially for expedited onboarding of temporary or urgent need providers.
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Requires dexterity to type at least 35 wpm. Required normal range of hearing and eyesight to record, prepare, and communicate appropriate reports and evaluations. Maintains and updates curriculum vitae/profiles for each provider.
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