Managed Care Credentialing Coordinator

2 months ago


Towson, United States Sheppard Pratt Full time
General Summary:

  • Provides administrative services to support the credentialing/paneling of PA and Affiliate providers with managed care companies and the enrollment of those providers with third party payors.
  • Processes credentialing/recredentialing materials and enrollment applications, tracks the credentialing status for all providers, interfaces with managed care companies.
  • Monitors delays in responses from companies, researching problems that impact enrollment.
  • Interfaces with Program Directors, Affiliate Directors and Administrators regarding the enrollment process and status of providers.
  • Establishes and maintains database of credentialing status and enrollment provider/rendering numbers.
  • Develops guidelines, instructions and the like to assist providers, providing articles for the Managed Care Minute and PA Pointers mailings as needed.
  • Collects data, prepares reports, and provides administrative support for program development.
  • Provides assistance with Sheppard Pratt's credentialing as needed.
Knowledge, Skills, and Abilities Required:
  • Work requires written and oral communication skills, the ability to compose correspondence, comprehensive knowledge of behavioral health billing requirements, and strong computer skills in Excel and Word - acquired through high school education and two to three years of administrative work experience.
    • Bachelor's degree and prior healthcare experience are preferred.
  • Work requires interpersonal skills sufficient to communicate effectively with P.A. clinicians, Division Directors, contracted clinicians, members of the insurance/managed care community, and other internal staff (21%-50% of work time).
  • Work requires proven project/program and problem-solving administrative skills using Word, Excel, ECHO, and IDX.
  • Work requires proficiency with ECHO database to effectively record information and produce reports according to managed care specifications.


  • Towson, Maryland, United States Sheppard Pratt Full time

    Job SummaryWe are seeking a highly organized and detail-oriented Credentialing Coordinator to join our team at Sheppard Pratt. In this role, you will be responsible for providing administrative support for the credentialing and paneling of PA and Affiliate providers with managed care companies.Key ResponsibilitiesProcess credentialing/recredentialing...


  • Towson, United States Kaiser Permanente Full time

    Job Summary:The Patient Care Coordinator is responsible for overseeing the management and coordination of care for the acute inpatient population. The PCC collaborates with rounding MAPMG Hospital Based Service Physicians, patient/family, nursing, utilization review and other members of the healthcare team to assure continuum of patient care progression for...


  • Towson, United States Kaiser Permanente Full time

    Description: Job Summary:The Patient Care Coordinator is responsible for overseeing the management and coordination of care for the acute inpatient population. The PCC collaborates with rounding MAPMG Hospital Based Service Physicians, patient/family, nursing, utlization review and other members of the healthcare team to assure continuum of patient care...


  • Towson, United States Recruitics JB Full time

    Job Summary: The Patient Care Coordinator is responsible for overseeing the management and coordination of care for the acute inpatient population. The PCC collaborates with rounding MAPMG Hospital Based Service Physicians, patient/family, nursing, utlization review and other members of the healthcare team to assure continuum of patient care progression for...


  • Towson, United States Disability Solutions Full time

    Job Summary: The Patient Care Coordinator is responsible for overseeing the management and coordination of care for the acute inpatient population. The PCC collaborates with rounding MAPMG Hospital Based Service Physicians, patient/family, nursing, utlization review and other members of the healthcare team to assure continuum of patient care progression for...


  • Towson, United States CMP Full time

    Job Summary: The Patient Care Coordinator is responsible for overseeing the management and coordination of care for the acute inpatient population. The PCC collaborates with rounding MAPMG Hospital Based Service Physicians, patient/family, nursing, utlization review and other members of the healthcare team to assure continuum of patient care progression for...


  • Towson, United States Kaiser Permanente Full time

    Description: Job Summary:The Patient Care Coordinator is responsible for overseeing the management and coordination of care for the acute inpatient population. The PCC collaborates with rounding MAPMG Hospital Based Service Physicians, patient/family, nursing, utlization review and other members of the healthcare team to assure continuum of patient care...


  • Towson, United States Kaiser Permanente Full time

    Description: Job Summary: The Patient Care Coordinator is responsible for overseeing the management and coordination of care for the acute inpatient population. The PCC collaborates with rounding MAPMG Hospital Based Service Physicians, patient/family, nursing, utlization review and other members of the healthcare team to assure continuum of patient care...


  • Towson, United States Kaiser Permanente Full time

    Job Summary:The Patient Care Coordinator is a key member of the healthcare team responsible for overseeing the management and coordination of care for the acute inpatient population at Kaiser Permanente. This role requires collaboration with physicians, nursing staff, and other healthcare professionals to ensure a continuum of patient care progression for...

  • Nurse Coordinator

    4 weeks ago


    Towson, Maryland, United States Ascension Full time

    Job SummaryWe are seeking a skilled Nurse Coordinator to join our team at Ascension Saint Agnes in Baltimore, Maryland. As a key member of our healthcare team, you will be responsible for coordinating nursing program activities and resources within our clinical specialty or department.Key ResponsibilitiesProgram Development and Oversight: Develop and oversee...


  • Towson, Maryland, United States Recruitics JB Full time

    Job Title:Manager of Inpatient Continuing CareCompany:Recruitics JBJob Summary:The Manager of Inpatient Continuing Care serves as a liaison between Recruitics JB and hospital facilities to facilitate open communication and ensure smooth transitions of care. This position is responsible for supervising and managing teams of personnel who support utilization...


  • Towson, United States Greater Baltimore Medical Center Healthcare Full time

    The Care Coordinator for Population Health is responsible for ensuring compliance with the quality goals and metrics set forth by the health system and various insurance carriers. This individual will assist in the design and implementation of population health management reports related to monitoring for gaps in care and care coordination activities. The...


  • Towson, Maryland, United States Greater Baltimore Medical Center (GBMC) Full time

    Job Title: Ambulatory Care CoordinatorAt Greater Baltimore Medical Center (GBMC), we are seeking a highly skilled and compassionate Ambulatory Care Coordinator to join our team. As a key member of our care team, you will play a vital role in ensuring the seamless coordination of patient care and promoting population health management.Key...


  • Towson, Maryland, United States Greater Baltimore Medical Center Healthcare Full time

    Job SummaryThe Greater Baltimore Medical Center Healthcare is seeking a highly skilled and dedicated Ambulatory Care Coordinator to join our team. As a key member of our population health management team, you will play a critical role in ensuring compliance with quality goals and metrics set forth by our health system and various insurance carriers.Key...


  • Towson, Maryland, United States Kaiser Permanente Full time

    Job Summary:The Patient Care Coordinator is responsible for overseeing the management and coordination of care for the acute inpatient population. This role requires collaboration with healthcare professionals, patients, and their families to ensure a seamless transition of care and optimal patient outcomes.Key Responsibilities:Conduct initial assessments...


  • Towson, Maryland, United States Recruitics JB Full time

    Job Summary:The Patient Care Coordinator is responsible for overseeing the management and coordination of care for the acute inpatient population. This role requires collaboration with the healthcare team to ensure a continuum of patient care progression for clinical and cost-effective outcomes.Key Responsibilities:Conduct initial face-to-face assessments...


  • Towson, United States Greater Baltimore Medical Center Healthcare Full time

    The Care Coordinator's primary responsibilities are to oversee coordination of care activities for a defined patient panel and to promote population health management by breaking down barriers and providing community, social supports, and health resources to the patient in a primary care setting. The Care Coordinator will work cooperatively with the Practice...


  • Towson, Maryland, United States Greater Baltimore Medical Center (GBMC) Full time

    Job SummaryWe are seeking a highly skilled and compassionate Ambulatory Care Coordinator to join our team at the Greater Baltimore Medical Center (GBMC). As a key member of our care team, you will play a vital role in coordinating patient care activities, promoting population health management, and breaking down barriers to access healthcare services.Key...


  • Towson, United States Greater Baltimore Medical Center (GBMC) Full time

    The Care Coordinator's primary responsibilities are to oversee coordination of care activities for a defined patient panel and to promote population health management by breaking down barriers and providing community, social supports, and health resources to the patient in a primary care setting. The Care Coordinator will work cooperatively with the Practice...


  • Towson, United States Greater Baltimore Medical Center Healthcare Full time

    The Care Coordinator's primary responsibilities are to oversee coordination of care activities for a defined patient panel and to promote population health management by breaking down barriers and providing community, social supports, and health resources to the patient in a primary care setting. The Care Coordinator will work cooperatively with the Practice...