Medical Staff Office Specialist Iii
3 weeks ago
**Job Summary**:
**Essential Responsibilities**:
- Pursues effective relationships with others by proactively providing resources, information, advice, and expertise with coworkers and members. Listens to, seeks, and addresses performance feedback; provides mentoring to team members. Pursues self-development; creates plans and takes action to capitalize on strengths and develop weaknesses; influences others through technical explanations and examples. Adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; helps others adapt to new tasks and processes. Supports and responds to the needs of others to support a business outcome.
- Participates in training and regulatory awareness by: may be assisting in the facilitation of orientation and training to newly appointed physician leaders for effective oversight and management of their departments credentialing, proctoring, privileging and reappointment processes, with regular review from manager; developing standard and nonstandard informational/educational documents (newsletters, memos) to communicate critical information regarding organizational programs and policies; beginning to develop and cultivate working relationships with key stakeholders, both internal and external, to ensure appropriate awareness of key issues and decision-making; and maintaining awareness of current internal policies and relevant external regulations and starting to provide standard and nonstandard consultative expertise to internal parties.
- Assists in quality assurance, improvement, and resolution by: obtaining and evaluating standard and nonstandard practitioner sanctions, complaints, and adverse data to ensure compliance, with regular review from manager; participating in ongoing assessments of standard and nonstandard governing documents (e.g., bylaws/rules and regulations/policies and procedures) to ensure continuous compliance; participating in surveys and audits of credentialing entities (e.g., CMOs, delegates and health plans for NCQA); facilitating efficient and cost-effective due process that complies with internal fair hearing and appeals policies and external legal and regulatory requirements, with regular review; identifying and escalating and preparing standard and nonstandard adverse actions/issues (e.g., sanctions and complaints) to the credentialing committee taken against a practitioner/provider in accordance with applicable law and contractual requirements to the necessary parties; and conducting audits and reconciliations of data between different departments, monitoring of credentialing and contracting, with regular review.
- Assists in governing databases by: maintaining structures and data within a computerized data base of physician data for use in the credentialling and appointment process, in alignment with department guidelines, with review.
- Enacts and analyzes data by: independently ensuring efficient file completion, conducting privileging analyses, and verifying privileging to the appropriate specialty/facility, based on data, with occasional review; and leveraging standard and nonstandard tools and policies to support knowledge management, record-keeping, and internal and external communication.
**Minimum Qualifications**:
- Minimum one (1) year(s) of experience with databases and spreadsheets.
- Associates degree in Business Administration, Health Care Administration, Nursing, Public Health, or related field AND minimum three (3) years of experience in clinical credentialing, accreditation and regulation, licensing, health care, quality, or a directly related field OR minimum four (4) years of experience in in clinical credentialing, accreditation and regulation, licensing, or a directly related field.
- Provider Credentialing Specialist Certificate within 36 months of hire
**Additional Requirements**:
- Knowledge, Skills, and Abilities (KSAs): Health Care Compliance; Delegation; Project Management; Health Care Quality Standards; Credentialling IT Application Software
PrimaryLocation : Maryland,Hyattsville,New Carrollton Administration
HoursPerWeek : 40
Shift : Day
Workdays : Mon, Tue, Wed, Thu, Fri
WorkingHoursStart : 08:30 AM
WorkingHoursEnd : 05:00 PM
Job Schedule : Full-time
Job Type : Standard
Employee Status : Regular
Employee Group/Union Affiliation : NUE-MAS-02|NUE|Non Union Employee
Job Level : Individual Contributor
Job Category : Quality & Safety
Department : Regional Office - Qlty Rsrc-Crdtlg-Regquant Rsk - 1808
Travel : No
-
Medical Staff Office Specialist III
24 hours ago
Hyattsville, United States Kaiser Permanente Full timeJob Summary: Requests and reviews primary source information and verifications, with regular review from manager. Identifies and plans for resolution of standard and nonstandard gaps in vendor relationships and escalates, as needed. Serves as a main point of contact for external queries regarding practitioner status. Evaluates applications and supporting...
-
Medical Billing Specialist
6 days ago
Hyattsville, United States Interdynamics Inc Full time**Who We Are** Interdynamics delivers a variety of mental health services to clients across the lifespan-from pediatric and school-based services, to addiction and substance use counseling, to individual behavioral health services, and much more. At Interdynamics Inc., we are client-focused, value-oriented, quality-obsessed, and people-centric. By joining...
-
Medical Billing Specialist
4 hours ago
Hyattsville, United States Interdynamics Inc Full timeJob DescriptionJob DescriptionWho We AreInterdynamics delivers a variety of mental health services to clients across the lifespan–from pediatric and school-based services, to addiction and substance use counseling, to individual behavioral health services, and much more. At Interdynamics Inc., we are client-focused, value-oriented, quality-obsessed, and...
-
Program Manager
3 weeks ago
Hyattsville, United States International Executive Service Corps Full timeProgram Manager (DAWIA Level III Contracting) - Adelphi, MD (3420) Location Adelphi, MD Job Code 3420 # of Openings 1 Program Manager (DAWIA Level III Contracting) - Adelphi, MD (3420) Kiliuda Consulting, LLC, a subsidiary of Three Saints Bay, LLC, and a Federal Government Contractor industry leader, is seeking a Program Manager (DAWIA Level III...
-
Hyattsville, United States Synergy Family Services Full time**Title**: PRP Rehabilitation Specialist/PRP Administrative Specialist** **Program**:Psychiatric Rehabilitation Program **Reports to**:PRP Program Director **Hours**:40 hours per week **QUALIFICATION CRITERIA**: **EDUCATION**:Licensed mental health professional, (LMSW,LCSW,LGPC,LCPC or CPRP) Rehabilitation Counselor certified by the Commission on...
-
Mid Level Contract Specialist
2 weeks ago
Hyattsville, United States PCI Government Services LLC Full timeDuties and Responsibilities The Mid-Level Contract Specialist shall provide advice, recommendations, and document support to multiple offices in all areas of the acquisition requirements phase. Mid-Level Contract Specialist support personnel shall coordinate with the Contracting Officer Representative (COR) on all requirement support services to include...
-
Facilities Operations Specialist
7 days ago
Hyattsville, United States National Experienced Workforce Solutions Full timeFacilities Operations SpecialistID:NPSNCA-004-003Location:HyattsvilleProgram:NPSWage/Hr:$35.00Hours/Week:24 hours per weekMinimum Age:55? This position supports the Museum Resource Center of the National Park Serice's National Capital Region and must be performed on site. ? The NPS Experienced Services Program is a unique partnership created to help...
-
Business Office Manager
3 days ago
Hyattsville, United States Medical Facilities of America Full timeBOM Full-time Experience in Long-term care billing Medicare and Medicaid preferred Job Duties and Responsibilities Ensure the billing process is efficient and proper coding of skilled services. Verify patients have a viable payer source. Coaching the families on Medicaid process and working alongside the family and case worker until approved Ensure daily...
-
Supervisory Emergency Management Specialist
2 weeks ago
Hyattsville, Maryland, United States Federal Emergency Management Agency Full timeWhat will I do in this position if hired?In this Supervisory Emergency Management Specialist (Recovery) position, you will be supervising a team of Individuals and Households Program staff for the IHP Branch Action Office, providing administrative and technical supervision necessary for management functions relative to the staff supervised including.Typical...
-
Supervisory Emergency Management Specialist
1 week ago
Hyattsville, United States Federal Emergency Management Agency Full timeWhat will I do in this position if hired? In this Supervisory Emergency Management Specialist (Recovery) position, you will be supervising a team of Individuals and Households Program staff for the IHP Branch Action Office, providing administrative and technical supervision necessary for management functions relative to the staff supervised...
-
Hyattsville, United States Synergy Family Services Full timeJob DescriptionJob Description EDUCATION: Licensed mental health professional, (LMSW,LCSW,LGPC,LCPC or CPRP) Rehabilitation Counselor certified by the Commission on Rehabilitation Certification or Bachelor’s prepared certified psychiatric rehabilitation practitioner certified by the U.S. Psychiatric Rehabilitation AssociationDUTIES AND...
-
Bilingual Homeless/Domestic Violence Specialist
3 hours ago
Hyattsville, United States Community Crisis Services Full timeJob DescriptionJob DescriptionSalary: $22.00 per hourThe Bilingual Homeless/Domestic Violence (HDV) Specialist works with the Homeless Services Director and Lethality Assessment Program Coordinator to ensure appropriate service delivery. Our HDVs provide direction and support to Hotline Specialists for homeless and domestic violence callers. Specialists are...
-
Medical Assistant
5 hours ago
Hyattsville, United States Your Wellness Sources Full timeJob DescriptionJob DescriptionSalary: We are seeking a Medical Assistant to perform various clinical and office duties to keep our healthcare practice running efficiently. Our practice is focus on wellness and you must be able to work directly with our team of medical providers to collect test samples, maintain patient records, explain common medical...
-
Admin/office Assistant
4 weeks ago
Hyattsville, United States Absolute Mental Health Care Solutions Full timeResponsibilities: - Provide administrative support to ensure efficient operation of the office - Answer and direct phone calls, take messages, and handle correspondence - Maintain filing systems, both physical and electronic, ensuring accuracy and organization - Coordinate and schedule appointments, meetings, and travel arrangements for staff - Bookkeeping...
-
Retail Sales Specialist
5 days ago
Hyattsville, United States Advantage Solutions Full timeDedicated Retail Sales Specialist Indeed Job Description Job description Full Time Retail Sales Specialist What We Offer: - Full Time Benefits (Medical, Dental, Vision, Life). - 401(K) with company match. - Generous Paid Time Off. - Paid training and ongoing career development. - Mileage reimbursement. What You’ll Do: - Flex your organizational...
-
Leasing Specialist
1 day ago
Hyattsville, United States Kay Apartment Communities Full timeJoin Kay Apartment Communities' leasing team at our **_665_**-unit apartment community in **West** **Hyattsville**, MD**. Kay's leasing specialists are the first point of contact with prospective residents and are also responsible for the satisfaction of our current residents, while helping attain leasing, retention and occupancy goals. They are committed to...
-
Certified Medical Assistant
5 hours ago
Hyattsville, United States Grayson HR Full timeJob DescriptionJob DescriptionWe are seeking a Medical Assistant to perform various clinical and office duties to keep our healthcare practice running efficiently. Our practice is focus on wellness and you must be able to work directly with our team of medical providers to collect test samples, maintain patient records, explain common medical procedures to...
-
Analyst III Vendor Support Services
1 month ago
Hyattsville, United States Retail Business Services Full timeAddress: USA-MD-Hyattsville-8301 Professional Place Ste115 Store Code: Vendor Support & Relationship Mgmt (5134838) Ahold Delhaize USA, a division of global food retailer Ahold Delhaize, is part of the U.S. family of brands, which also includes five leading omnichannel grocery brands - Food Lion, Giant Food, The GIANT Company, Hannaford and Stop & Shop....
-
Pediatrician
2 days ago
Hyattsville, United States Mid-Atlantic Permanente Medical Group Full timeThe Mid-Atlantic Permanente Medical Group (MAPMG) proudly provides the highest quality integrated care for over 800,000 members in Virginia, Maryland, and the District of Columbia. We invite applications for a specialist in Pediatrics at our West Hyattsville location.In collaboration with the Kaiser Foundation Health Plan of the Mid-Atlantic States, we...
-
Pediatrician
7 hours ago
Hyattsville, United States Kaiser Permanente -Mid-Atlantic Permanente Medical Group Full timeThe Mid-Atlantic Permanente Medical Group (MAPMG) proudly provides the highest quality integrated care for over 800,000 members in Virginia, Maryland, and the District of Columbia. We invite applications for a specialist in Pediatrics at our West Hyattsville location.In collaboration with the Kaiser Foundation Health Plan of the Mid-Atlantic States, we...