- AdventHealth (Altamonte Springs, FL)
- …day-to-day credentialing and privileging issues as they arise. + Assists with managed care delegated credentialing audits; conducts internal file audits. ... Professional Medical Staff Management (CPMSM) Preferred Or Certified Provider Credentialing Specialist (CPCS) Preferred Additional Licenses and Certifications… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Managed Care Credentialing Specialist position is responsible for the timely and accurate completion and submission of ... commercial managed care plans and medicare and medicaid. The Managed Care Credentialing Specialist position has consistent interaction with the… more
- BayCare Health System (FL)
- …currently reside in Florida. Responsibilities + Responsible for initiating and maintaining credentialing , managed care provider enrollment and hospital ... Preferred associate or bachelor's degree preferred. Experience + Required - 1 year Credentialing or 1-year Managed Care Equal Opportunity Employer… more
- The County of Los Angeles (Los Angeles, CA)
- CREDENTIALING SPECIALIST Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/3476028) Apply CREDENTIALING SPECIALIST Salary $65,911.68 ... for periodic audits by Consolidated Accreditation and Licensure Survey and Office of Managed Care as requested; conducts internal reviews; and completes required… more
- Robert Half Office Team (Richmond, VA)
- …to apply your expertise in credentialing processes and compliance within the managed care sector. Join a dynamic team where your skills will ensure ... Description We are looking for a dedicated Credentialing Specialist to support healthcare operations...compliance with Medicare, Medicare Advantage, and managed care organization standards. * Manage the end-to-end credentialing… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …am to 5 pm **Work Location:** El Paso **Preferred Qualifications:** + Three years of Credentialing experience in a managed care plan, medical staff services ... **42129BR** **Extended Job Title:** Medical Staff Credentialing Specialist **Org Level 1:** Texas...education and experience is required + Three years of Credentialing experience in a managed care… more
- Highmark Health (Harrisburg, PA)
- …Committee and Allied Health Professional Subcommittee agendas in order to comply with Managed Care requirements. (5%) + Performs other duties as assigned or ... and privileging, medical education, hospital environment, health insurance or managed care + 1 year in customer...+ 1 year in customer service + Certified Provider Credentialing Specialist (CPCS) **OR** Certified Professional Medical… more
- Lawrence General Hospital (Lawrence, MA)
- …requires two years' recent experience in a hospital or managed care -related position with knowledge of Medical Staff credentialing , working knowledge of ... As the Credentialing Specialist , you will be responsible for assisting in the planning, implementation and operations of the medical staff credentialing … more
- CareFirst (Baltimore, MD)
- …**Education Level:** High School Diploma or GED. **Experience:** 3 years physician credentialing experience or health insurance/ managed care operations ... performing verification and/or appropriate actions. **Licenses/Certifications** : Certified Provider Credentialing Specialist (CPCS) Preferred Salary Range: $38,520… more
- BayCare Health System (Tampa, FL)
- …the onboarding process and to resolve issues in onboarding and managed care enrollment. + Assists the Credentialing Manager with NCQA Accreditation renewals. ... years - Credentialing or 3 years - Managed Care + Preferred Certification includes Certified... Care + Preferred Certification includes Certified Provider Credentialing Specialist (CPCS) or Certified Provider Medical… more
- Henry Ford Health System (Troy, MI)
- … or related field or four (4) years of related experience in healthcare industry, managed care experience in lieu of degree. + Bachelor's degree in business, ... + Minimum of two (2) years of experience in managed care experience. + Minimum of two...desirable. CERTIFICATIONS/LICENSURES REQUIRED: + Certification as CPCS (Certified Provider Credentialing Specialist ) or CMSC (Certified Medical Staff… more
- OhioHealth (Marion, OH)
- …(Required) **Additional Job Description:** **degree and two years' experience in the healthcare, managed care , credentialing or medical staff services field ... or equivalent combination of education and 7+ years' experience in healthcare, managed care , credentialing or medical staff services field** **SPECIALIZED… more
- HCA Healthcare (Denver, CO)
- … credentialing in a healthcare facility (ie, Medical Staff Office), managed care setting, or credentials verification organization. CERTIFICATE/LICENSE - ... join an organization that invests in you as a(an) Credentialing Coordinator? At HealthONE Colorado Care Partner,...Certified Provider Credentialing Specialist or Certified Profession in Medical… more
- Houston Methodist (Houston, TX)
- …the designated area(s) of responsibility or populations served. The Pharmacy Clinical Specialist position supports the delivery of pharmacy managed protocols, ... At Houston Methodist, the Pharmacy Clinical Specialist position is responsible for performing advanced clinical pharmacy duties enabling the delivery of optimal… more
- Organon & Co. (Plymouth Meeting, PA)
- …utilization while meeting the needs of customers. + Understanding of the local managed care and reimbursement environment relevant to various customer segments ... their current practice structure, business model, and key influencers (ex: Managed Care Organization/payers, Management Service Organizations (MSOs), employers,… more
- Integra Partners (Troy, MI)
- …compliance, regulatory affairs, and/or utilization management within a health plan or managed care environment + Demonstrated expertise in CMS and state ... The Medical Policy & Compliance Specialist is responsible for researching, analyzing, and interpreting...Medicaid, and NCQA regulations relevant to Utilization Management (UM), Credentialing and Claims, with the ability to translated them… more
- Houston Methodist (The Woodlands, TX)
- …the designated area(s) of responsibility or populations served. The Pharmacy Clinical Specialist position supports the delivery of pharmacy managed protocols, ... At Houston Methodist, the Pharmacy Clinical Specialist position is responsible for performing advanced clinical pharmacy duties enabling the delivery of optimal… more
- Sedgwick (Salem, OR)
- …Network Specialist **PRIMARY PURPOSE** **:** To ensure clients and Managed Care Organization's covered employees are provided information on eligibility, ... three (3) years of customer service and one (1) year of analytical experience. Managed Care experience preferred. **Skills & Knowledge** + Thorough knowledge of… more
- Tenet Healthcare (Detroit, MI)
- …equivalent education/training strongly preferred. 2. Two years of medical affairs office or credentialing experience in managed care , hospital, or physician ... Credentials Specialist Full Time Days - 2506000537 Description :...Detroit Medical Center (DMC) is a nationally recognized health care system that serves patients and families throughout Michigan… more
- Ochsner Health (Morgan City, LA)
- …physician members and executive leadership team. Coordinates physician quality information and managed care audits and manages documentation and maintenance of ... experience. **Certifications** Required - None. Preferred - Certified Provider Credentialing Specialist and/or Certified Professional Medical Services Management… more