Credentialing Specialist Job Opening

JOB SUMMARY This role is responsible for all aspects of credentialing and re-credentialing for all Cornerstone Home Health, Hospice and Private Duty Agencies. Acts as the liaison between our Agencies and our managed care plan partners. Identifies new contracting opportunities, develops and maintains tools and processes to support the completion of timely and compliant managed care provider applications. Qualified candidate will have a minimum of three years of experience in credentialing.

DUTIES & RESPONSIBILITIES

This full time position reports to the Director of Managed Care and is responsible for all aspects of credentialing and re-credentialing for our locations across the organization. Coordinates and supports the completion of timely and compliant managed care provider applications. Acts as the liaison between our entities and our managed care plan partners.

• Works independently to ensure full compliance with all applicable policies, procedures, bylaws, rules and regulations, accreditation standards and regulations for the processing of applications for initial credentialing and re-credentialing.
• Ensures all applications and requirements for credentialing are processed according to regulations and policies as outlined by provider.
• Confirms the seamless and timely flow of credentialing information in order to meet deadlines.
• Coordinates with our Legal, HR, and Compliance Departments to verify and document pertinent information.
• Maintains copies of current state licenses, CLIAs, COIs, surveys and other required credentialing documentation.
• Coordinate and maintain the credentialing management database.
• Expected to represent our Agencies and company professionally to all managed care plans and external partners.
• Assist Managed Care Resources and team with special contracting projects as assigned.
• Coordinates with Managed Care Resource to file and maintain contract database.
• Administrative task including maintaining meeting notes, filing contracts, processing credentialing inbox, etc.

The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

JOB REQUIREMENTS (Education, Experience, Knowledge, Skills & Abilities) Qualified candidate must have a bachelor's degree in a healthcare related field or 3 + years in a similar position. Proven strong organizational skills and attention to detail. These are absolutely necessary. Demonstrated professionalism and exceptional interpersonal skills. Ability to adhere to strict confidentiality guidelines and operate with the utmost integrity and discretion. Strong written and verbal communication skills required. Teamwork orientation. Able to follow through with delegated tasks and accountability. Resourcefulness in problem solving. Intermediate to advanced computer skills including proficiency in MS Office applications (Excel, Word, Outlook, PowerPoint) along with Adobe PDF. Dedicated to results. Knowledge of commonly used credentialing concepts, practices and procedures. Excellent time management and multi-tasking abilities. Demonstrated ability to function independently with minimal direct supervision.

Desired Qualifications:

• Credentialing experience preferred
• AA degree preferred
• Must be able to work from our Service Center located in Eagle, Idaho

Additional Information

We are committed to providing a competitive Total Rewards Package that meets our employees needs. From a choice of medical, dental and vision plans to retirement savings opportunities through a 401(k), company match and various other features, we offer a comprehensive benefits package. We believe in great work and we celebrate our employees' efforts and accomplishments both locally and companywide, recognizing people daily through our Moments of Truth Program. In addition to recognition we believe in supporting our employees' professional growth and development. We provide employees a wide range of free e-courses through our Learning Management System as well as training sessions and seminars. For more information, please go to www.ensignbenefits.com

Compensation: Based on experience.

Type: Full Time

Location:

Cornerstone Service Center

1675 E. Riverside Drive, #200

Eagle, ID 83616

If interested in this position, please submit a resume for consideration. We look forward to hearing from you!