Certified Healthcare Provider Specialist
2 weeks ago
We are seeking a skilled Certified Healthcare Provider Specialist to join our team at PROMESA R.H.C.F. The successful candidate will be responsible for managing credentialing and privileging functions network-wide.
Key Responsibilities:- Credentialing Management: Responsible for the credentialing and privileging of all employed/contracted licensed independent practitioners and other licensed/certified healthcare providers for all entities under Acacia Network.
- Compliance Development: Develop an annual credentialing compliance work plan including a risk assessment of the processes.
- Policies and Procedures: Develop, initiate, maintain and update policies, protocols and forms for credentialing/privileging aspects of the program to ensure quality care, continued accreditation and/or designations.
- Implementation and Monitoring: Drive implementation of day-to-day credentialing compliance controls. Maintain current knowledge of changes in industry rules and regulations and assist in maintaining effective lines of communication with other departments to ensure these changes are disbursed appropriately.
- Education: HS diploma or GED required, Bachelor's degree preferred.
- Credentials: Certified Provider Credentialing Specialist (CPCS) preferred.
- Experience: 2+ years of supervisory experience is required, 5+ years of credentialing experience is required.
- Skills: Strong knowledge of credentialing/privileging procedures and requirements, including managed care process, thorough knowledge of and proficiency with Windows based systems.
The estimated salary for this role is $85,000 - $115,000 per year, depending on experience and qualifications.
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