PHP Credentialing Specialist

6 days ago


Paducah, Kentucky, United States Baptist Health Full time
Job Title: PHP Credentialing Specialist

Baptist Health is committed to fostering a collaborative and professional work environment that encourages our employees to thrive. As a PHP Credentialing Specialist, you will play a vital role in providing high-quality care to our patients and promoting excellence in our communities.

Key Responsibilities:
  • Manage the credentialing and re-credentialing process for healthcare providers, ensuring compliance with regulatory requirements.
  • Develop and maintain relationships with payors, healthcare providers, and other stakeholders to ensure seamless communication and coordination.
  • Prepare and execute annual delegated credentialing network/payor audits to ensure accuracy and compliance.
  • Provide education and training to office managers and staff on local managed care issues and market changes.
  • Promote good public relations for Purchase Health Partners (PHP) and serve as a liaison between PHP and healthcare providers.
  • Assist the PHP Coordinator and AVP Networks and Collaboration with other duties as assigned.
Requirements:
  • Bachelor's degree in a related field, such as healthcare management or a related field.
  • Minimum 5 years of experience in healthcare management, credentialing, or a related field.
  • Proven communication and quantitative skills, with the ability to prioritize multiple tasks and meet deadlines.
  • Supervised by the PHP Coordinator, with performance evaluations conducted on a yearly basis.

Baptist Health is an Equal Employment Opportunity employer and is committed to providing a safe and healthy work environment for all employees. We require compliance with our infectious disease and vaccination policies, which include mandatory vaccination policies for influenza and COVID-19, unless reasonable accommodations are needed under applicable law.



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