Starting Pay: DOE
Location: City Heights
Hours of Work: TBD
Status/Hours: Full Time/ Non-Exempt
The Credentialing Manager position will prepare and maintain credentialing files and reports for all individual providers including maintenance of credentialing files, provider rosters and spreadsheets to comply with group delegation requirements. This position ensures all health care professionals are appropriately credentialed, which includes the responsibility of maintaining current information on file and within the credentialing database.
Work with onboarding and implementation manager to:
• Ensure accuracy in gathered documents and information for credentialing to begin.
• Oversees and manages the completion of health care professionals credentialing and re-credentialing applications.
• Monitors all verification sources.
• Support and assist staff with any process questions and or issues.
• Provide training assistance to team where credentialing content is concerned.
• Attend monthly credentialing meeting with our CMO and Executive Director.
• Maintain credentialing software and ensure timely payer follow-up for all customers.
• Monitor communications to practices and providers for all monthly status reports.
• Effectively communicate with assigned customers at all levels and serve as the main point of contact for any escalated situations.
• Maintains all required documents for delegated credentialing.
• Supervise, coach, support and mentor credentialing staff and conduct 1:1 monthly meeting to do so.
• Be a positive, result driven, professional team player always.
• Assist with annual delegated credentialing audits and National Committee on Quality Assurance (NCQA) audits.
•Performs other duties as assigned.
Certification required: Certified Professional Medical Services Management (CPMSM) or Certified
Professional Credentialing Specialist (CPCS) certification required.
• Minimum of 3 years in a management position.
• Minimum of 2 years in medical provider credentialing and contracting.
• Must possess technical knowledge of credentialing data management systems.
Interested Applicants please submit Cover Letter and Resume down below or to:
Human Resources Department
La Maestra Community Health Centers is an equal opportunity employer and does not
discriminate on the basis of race, religion, color, sex, national origin, age, sexual orientation, gender, disability or any other legally protected status.
|Education:||High school diploma or equivalent. Bachelor’s Degree Preferred.|
|Certification/Licensure:||Certified Provider Credentialing Specialist (CPCS) preferred.|
|Verbal and Written Skills to perform the job:||Bilingual (English/Spanish). Familiarity with basic word processing, spreadsheet, and database applications. Accurate keyboarding skills.|
|Technical knowledge and skills required to perform the job:||Excellent verbal, written and interpersonal communication skills and the demonstrated ability to work with diverse individuals and groups. Demonstrate high levels of self-initiation and direction. Knowledge of communities we serve. Knowledge and experience working in medical settings and interacting collaboratively with medical teams. Skill in analyzing situations and making timely decisions.|
|Physical and Mental Requirements:||Work involves sitting, talking, hearing, using hands to handle, feel or operate objects, tools, or controls, and reaching with hands and arms. The employee may be required to push, pull, lift, and/or carry up to 20 pounds. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.|