Current jobs related to Health Partners Credentialing Specialist - Gainesville, Georgia - Northeast Georgia Health System, Inc
-
Health Partners Credentialing Specialist
1 month ago
Gainesville, Georgia, United States Northeast Georgia Health System Inc Full timeAbout the RoleThis position plays a critical role in ensuring the smooth operation of the Health Partners Network by performing day-to-day duties and tasks related to the credentialing of practitioners and facilities.Key ResponsibilitiesProcess initial appointments and re-appointments for Health Partners practitioners and facilitiesVerify credentials,...
-
Behavioral Health Specialist
2 weeks ago
Gainesville, Georgia, United States Avita Community Partners Full timeJob SummaryAvita Community Partners is seeking a skilled Behavioral Health Specialist to join our team. As a key member of our community mental health team, you will provide a broad range of paraprofessional behavioral health and social services to clients and their families.Key Responsibilities:Organize and facilitate groups under supervision.Participate in...
-
Certified Peer Specialist
2 weeks ago
Gainesville, Georgia, United States Avita Community Partners Full time**Career Opportunity with Meaning**Are you passionate about improving the quality of life for individuals with severe and persistent mental illness (SPMI) and co-occurring substance abuse disorders? Avita Community Partners offers a unique chance to make a difference in the lives of others.As a Peer Specialist, you will work with clients in our 24/7...
-
Behavioral Health Specialist
3 weeks ago
Gainesville, Georgia, United States Avita Community Partners Full timeAvita Community Partners: A Leader in Behavioral Health ServicesWe are seeking a highly skilled and compassionate Behavioral Health Counselor to join our team at Avita Community Partners. As a leading provider of behavioral health services, we are committed to delivering high-quality care to individuals and families in need.Key Responsibilities:Counsel and...
-
Behavioral Health Specialist
3 weeks ago
Gainesville, Georgia, United States Avita Community Partners Full timeAvita Community Partners: A Leader in Behavioral Health CareWe are seeking a highly skilled and compassionate Behavioral Health Counselor to join our team at Avita Community Partners. As a key member of our clinical services team, you will play a vital role in delivering high-quality care to individuals and families in need.Key Responsibilities:Counsel and...
-
Licensed Mental Health Therapist
2 months ago
Gainesville, Georgia, United States Avita Community Partners Full timeAbout the RoleWe are seeking a highly skilled and compassionate Licensed Mental Health Therapist to join our team at Avita Community Partners. As a Crisis Intervention Specialist, you will play a critical role in providing high-quality care to individuals experiencing mental health crises and/or in need of detoxification from substances.Key...
-
Health Services Specialist
3 weeks ago
Gainesville, Georgia, United States Avita Community Partners Full timeJoin Our Team at Avita Community PartnersWe are seeking a dedicated and compassionate Health Services Technician to join our innovative program for women in recovery. As a valued member of our team, you will have the opportunity to make a meaningful difference in the lives of our clients.At Avita Community Partners, we prioritize the well-being and success...
-
Case Manager
2 weeks ago
Gainesville, Georgia, United States Avita Community Partners Full timeWhy Choose Avita Community Partners?At Avita Community Partners, we offer a comprehensive benefits package that includes medical, dental, vision, life insurance, short/long-term disability, and more. We also contribute 3.5% of your salary to a 401k plan to help you save for retirement.20 days of Paid Time Off (PTO) per year, with a full cash out for unused...
-
Certified Peer Specialist
4 weeks ago
Gainesville, Georgia, United States Avita Community Partners Full timeJob Title: Certified Peer SpecialistAvita Community Partners is seeking a Certified Peer Specialist to join our team.Job Summary:We are looking for a highly motivated and compassionate individual to provide support and guidance to individuals with severe and persistent mental illnesses. As a Certified Peer Specialist, you will work under the clinical...
-
Certified Peer Specialist
1 month ago
Gainesville, Georgia, United States Avita Community Partners Full timeJob Title: Certified Peer SpecialistAvita Community Partners is seeking a Certified Peer Specialist to join our team.Job Summary:We are looking for a highly motivated and compassionate individual to provide support and guidance to individuals with severe and persistent mental illnesses. As a Certified Peer Specialist, you will work under the clinical...
-
Certified Peer Specialist
3 weeks ago
Gainesville, Georgia, United States Avita Community Partners Full timeJob Title: Certified Peer SpecialistAvita Community Partners is seeking a Certified Peer Specialist to join our team.Job Summary:We are looking for a highly motivated and compassionate individual to provide support and guidance to individuals with severe and persistent mental illnesses. The successful candidate will have clinical skills and experience to...
-
Mental Health Counselor
3 weeks ago
Gainesville, Georgia, United States Avita Community Partners Full timeAvita Community Partners: A Leader in Mental Health ServicesWe are seeking a highly skilled and compassionate Mental Health Counselor to join our team at Avita Community Partners. As a leading provider of mental health services, we are dedicated to delivering high-quality care to children and adolescents in a school and outpatient setting.Key...
-
Behavioral Health Therapist
2 weeks ago
Gainesville, Georgia, United States Avita Community Partners Full timeAvita Community Partners is seeking a skilled Behavioral Health Counselor to join our team. As a Behavioral Health Counselor, you will be responsible for implementing effective treatment plans to clients in an individual or group setting.Responsibilities:Counsel and advise individuals or groups with an SMPI diagnosis.Develop and implement individual...
-
Health Information Management Specialist
2 weeks ago
Gainesville, Georgia, United States Northeast Georgia Health System, Inc Full timeJob Title: Health Information Management SpecialistJob Summary:We are seeking a highly organized and detail-oriented Health Information Management Specialist to join our team. The successful candidate will be responsible for managing and maintaining accurate and confidential patient records, ensuring compliance with HIPAA regulations and organizational...
-
Licensed Mental Health Therapist
1 month ago
Gainesville, Georgia, United States Avita Community Partners Full timeJob Opportunity at Avita Community PartnersWe are seeking a skilled and compassionate Licensed Mental Health Therapist to join our team at Avita Community Partners. As a crisis counselor, you will play a vital role in providing high-quality care to individuals experiencing mental health crises and substance abuse issues.About the RoleAs a crisis counselor,...
-
Mental Health Case Manager
1 week ago
Gainesville, Georgia, United States Avita Community Partners Full timeJob Summary: We are seeking a highly motivated and compassionate Mental Health Case Manager to join our team at Avita Community Partners. As a key member of our clinical treatment team, you will play a vital role in delivering support services to individuals with severe and persistent mental illness or co-occurring substance abuse issues in the community.Key...
-
Mental Health Case Manager
2 weeks ago
Gainesville, Georgia, United States Avita Community Partners Full timeJob Summary:Avita Community Partners is seeking a skilled Mental Health Case Manager to join our team. As a key member of our clinical treatment team, you will play a vital role in delivering support services to improve the functionality of clients with severe and persistent mental illness or co-occurring substance abuse issues in the community.Key...
-
Mental Health Support Specialist
4 weeks ago
Gainesville, Georgia, United States Northeast Georgia Health System Full timeAbout the RoleClinical SupportWe are seeking a skilled Clinical Support professional to join our team at Northeast Georgia Health System. As a Clinical Support Specialist, you will play a vital role in providing high-quality patient care and support services in our behavioral health setting.Key ResponsibilitiesObtain initial patient information and document...
-
Mental Health Support Specialist
2 weeks ago
Gainesville, Georgia, United States Northeast Georgia Health System Full timeAbout the Role:Clinical SupportWork Schedule:7 Days on 7 Days OffNortheast Georgia Health System is committed to delivering exceptional patient care and improving the health of our communities.Job Summary:As a Clinical Support Specialist, you will play a vital role in maintaining the therapeutic milieu and ensuring the comfort and safety of our patients. You...
-
Substance Abuse Therapist
3 weeks ago
Gainesville, Georgia, United States Avita Community Partners Full timeSubstance Abuse Counselor OpportunityAvita Community Partners is seeking a dedicated and compassionate Substance Abuse Counselor to join our Assertive Community Treatment (ACT) Team. As a key member of our team, you will provide essential support services to individuals with severe and persistent mental illness, substance abuse, and developmental...
Health Partners Credentialing Specialist
2 months ago
This position is responsible for performing day-to-day duties and tasks related to the credentialing of practitioners and facilities to participate with the Health Partners (HP) Network.
Key Responsibilities- Process initial appointments and re-appointments for practitioners and facilities, ensuring compliance with established eligibility criteria and completeness of supporting documentation.
- Credential practitioners and facilities according to NCQA standards and the approved Health Partners credentialing program.
- Conduct primary source verification of credentials, including licensure, licensure sanction activity, DEA certificate, work history, professional liability insurance, education, training & board certification, hospital privileges, and disciplinary action history.
- Initiate contact with applicants and their staff for orientation and educational purposes, and schedule meetings to facilitate the on-boarding process.
- Coordinate activities related to the Health Partners Credentials Committee, including preparation and distribution of Credentialing Committee reports.
- Participate in Credentials Committee meetings, take minutes as assigned, and draft and distribute them to committee members for review and approval.
- Coordinate and process the entry of credentialing-related information into the appropriate software application in a timely and accurate fashion.
- Track timeliness of provider loads by payer, including date submitted, date confirmation received, error rate, and corrections needed.
- Audit provider loads once confirmed by the payer for accuracy, report errors to the payer, and monitor progress and resolution.
- Monitor receipt of payer effective date notices, contact payers to follow up on enrollment status, secure provider numbers, effective dates, and confirmation letters.
- Participate in the quarterly demographic update process and follow up as deemed necessary.
- Take the lead with payers in monitoring the progress of payer enrollment for NGPG providers, notify management of payer noncompliance, and resolve any issues that may arise.
- Enter and update all NGPG provider demographics into hospitalist group database for tracking and reporting purposes.
- Actively participate in the NCQA accreditation process, including preparation, submission, and on-site survey.
- Act as a liaison between the Health Partners, providers, employers, payers, and Medical Staff Services (Central Verification Office).
- Assist with invoicing and collecting the annual HP participation fees from providers.
- Maintain regulatory compliance and promote quality customer service, ensuring provider satisfaction issues regarding noncompliance with credentialing program are investigated, reported, and appropriate action is taken to resolve the issue.
- Licensure or other certifications: Bachelor's Degree
- Minimum Experience: Minimum two (2) years credentialing experience in a managed care organization, hospital, or physician environment
- Preferred Licensure or other certifications: CPCS certification
- Preferred Experience: Knowledge of NCQA standards
Northeast Georgia Health System, Inc. is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status.
