Medical Staff Coordinator, Huntington Hospital, Pasadena, CA

Posted on August 5th, 2019

Job ID: 105364
Category: Clerical
Department: Medical Staff
Shift: Days
Hours: Full Time

When you join Huntington Hospital in Pasadena, CA, you are aligning yourself with an organization whose values drive our philosophy of care. Our focus on delivering quality, service, and cutting edge care, enables Huntington Hospital to be an organization committed to patient outcomes-not the bottom line. More importantly, it empowers you to enact change and deliver the results that continuously improve our ability to provide our community with care.
 
The Medical Staff Coordinator is responsible for medical staff services functions to meet the needs of the medical staff and is responsible for Credentialing, Recredentialing and Meeting Management. Works with Hospital Administration and the Medical Staff to direct and coordinate administrative support and provide resources needed for the medical staff to enable them to fulfill their duties and obligations as defined by the Medical Staff Bylaws, Rules and Regulations and policies and procedures. Ensures compliance with The Joint Commission Standards, Title 22 Regulations and other regulatory agencies. This position requires flexibility of hours.

Experience/Training: 
Working knowledge of Medical Staff principles and operations specific to regulatory expectations. Comprehensive understanding of medical terminology. Excellent verbal and written communication skills, independent problem solving and decision making skills, critical thinking ability, attention to details and high degree of accuracy. Excellent customer service skills. Computer literacy to include extensive word processing skills, Microsoft Outlook, Word, Excel, PowerPoint, Medical Staff Software. At least three years experience in Medical Staff Services Department, with meeting management.

Education: 
Minimum High School Diploma. Bachelor’s degree preferred.

Licenses/Certifications:

CPMSM or CPCS certification preferred on entry. Required within 2 years of hire/transfer.

Skills:

Problem solving and conflict resolution skills are necessary. Ability to establish prioritize work assignments. Good working knowledge of medical staff organization. Computer and database literacy is required. Ability to express ideas effectively, orally and in writing. Must possess organizational skills.

Innovating the delivery of healthcare as the San Gabriel Valley region’s only Level II Trauma Center and Level III NICU, Huntington Hospital is a 635-bed non-profit regional medical center. We deliver nationally recognized care across over 90 service areas to our community and beyond. 

Located in downtown Pasadena, you’ll find yourself among charming neighborhoods and a relaxed community that is still close enough to all that L.A. has to offer. So join us, and find out what it’s like to discover Careers at a Higher Level™.

APPLY HERE: https://d.hodes.com/r/tp2?e=se&tv=pixel_tracker&p=web&aid=huntington&se_ca=misc&se_ac=click&se_la=6710&u=https%3A%2F%2Fwww.hhcareers.com%2Fjob%2F9917094%2Fmedical-staff-coordinator-pasadena-ca%2F%3Futm_source%3Dcamss%26utm_campaign%3Dnull%26utm_medium%3Dmcloud-misctags%26utm_term%3D6710_Medical%2520Staff%2520Coordinator%2520posting

Provider Services Credentialing Specialist, Central California Alliance for Health, Scotts Valley, CA

Posted on July 29th, 2019

We have an opportunity to join the Alliance as a Provider Services Credentialing Specialist in the Provider Services Department.
 
WHAT YOU'LL BE RESPONSIBLE FOR
Reporting to the Provider Services Credentialing Supervisor, you will coordinate the provider credentialing function for your assigned county and perform application intake and ensure that the credentialing database accurately reflects provider credential files and primary source data. You will also perform ongoing monitoring of license status and state and federal sanctions of contracted and non-contracted providers, collaborate with other Credentialing staff to support Peer Review Credentialing Committee (PRCC) meetings, and ensure successful data integrations with other organizational databases for proper claims payment and provider data reporting.

THE IDEAL CANDIDATE WILL HAVE

• Experience performing provider credentialing functions, working with credentialing software (eVips preferred), and performing data entry and data analysis
• Experience working in a County Organized Health System
• Bachelor's degree in Social Science, Business Administration, Healthcare of related field

WHAT YOU'LL NEED TO BE SUCCESSFUL
To read the full position description, and list of requirements click here (http://www.ccah-alliance.org/positions/Provider_Services_Credentialing_Specialist.pdf)
Knowledge of:

• Methods and techniques of data entry and data auditing
• Methods and techniques of research, analysis and reporting
• Healthcare terminology
• Managed care concepts

Ability to:

• Understand and interpret policies, procedures, regulations and contract language
• Identify and troubleshoot potential and actual problems, identify alternative solutions and make recommendations for action
• Proofread, verify, analyze and audit data
• Quickly become familiar with providers and credentialing activities in assigned county

Education and Experience:

• Associate’s degree and a minimum of four years (or high school diploma or equivalent and a minimum of five years) of experience in a healthcare environment performing credentialing, compliance or office management functions; or an equivalent combination of education and experience may be qualifying

BENEFITS:

• Medical, Dental and Vision Plans
• Ample Paid Time Off
• 11 Paid Holidays per year
• 401(a) Retirement Plan
• 457 Deferred Compensation Plan
• Robust Health and Wellness Program
• EV Charging Stations
• And many more! (http://benefits.filice.com/centralcalifornia/2019/benguide.pdf)

For a complete position description and to apply online, please visit our careers website at https://grnh.se/5edcf22d1

ABOUT US
We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us.

Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve over 330,000 members in Santa Cruz, Monterey and Merced counties. To learn more about us, click here (http://www.ccah-alliance.org/aboutus.html) or check out this video (https://www.youtube.com/watch?v=yI4SyyIimiU). 

At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for sponsorship.

The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status.

Credentialing Specialist, Clever Care Health Plan, Orange County, CA

Posted on June 20th, 2019

About Clever Care Health Plan:

• Clever Care Health Plan is a new Medicare Advantage insurance company (started in 2019; www.clevercarehealthplan.com). We plan to serve Medicare beneficiaries in Southern California. Our office is located at Little Saigon in Orange County (8990 Westminster Blvd, Westminster, CA 92683).  We are passionate in providing best services to our healthcare providers. Our goal is to be the best partner for our providers by creating an easy, reliable and fast credentialing services.

Position Summary:

• The Credentialing Specialist is responsible for ensuring that healthcare providers meet federal and state requirements. He/she is responsible for all aspects of the credentialing and re-credentialing processes of professional and institutional health providers. Maintain up-to-date data for each provider in credentialing databases and online systems; ensure timely renewal of licenses and certifications. Competitive compensation with health insurance benefit.

Job Functions and Responsibilities:

• This position is responsible to:
  • Ensure heath care providers in the health plan’s network are in good standing. All providers meet federal and state requirements to serve Medicare beneficiaries.
  • Review credentialing files and work with healthcare providers to obtain missing, incomplete and expiring items.
  • Compiles and maintains current and accurate data for all providers.
  • Completes provider credentialing and re-credentialing applications; complete primary-source verification; monitors applications and follows-up as needed.
  • Completes location credentialing and re-credentialing applications; monitors applications and follows-up as needed.
  • Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers.
  • Maintains corporate provider contract files.
  • Maintains knowledge of current health plan and agency requirements for credentialing providers.
  • Sets up and maintains provider information in online credentialing databases and system.
  • Tracks license and certification expirations for all providers to ensure timely renewals.
  • Ensures practice addresses are current with health plans, agencies and other entities.
  • Maintains information in credentialing database.
  • Audits health plan directories for current and accurate provider information.
  • Participates and health plan audits
  • Establish and maintain long-term working relationships with healthcare providers to ensure customer satisfaction and retention.
  • Maintain an accurate and reliable provider database for our members.
  • Maintain consistent contact with healthcare providers to ensure that expectations are clear and requirements are completed in a timely manner.
  • Utilize advanced problem-solving skills to resolve issues and conflicts that may arise.
  • Performs other duties as assigned.

Qualifications:

• Associate degree or Highschool diploma.
• 2 years of experience in provider credentialing. Practical-knowledge to use NPDB or Credentialing software.
• Ability to speak in Vietnamese or Chinese Mandarin fluently.
• Well-organized and detail orientated. Professional demeanor. Strong customer service.
• Certified Provider Credentialing Specialist (CPCS) is preferred.

Please email your resume directly to Human.Resources@CleverCareHealthPlan.com

Hospital Credentialing Specialist, Radiology Partners, El Segundo, CA

Posted on June 13th, 2019

POSITION OVERVIEW
Job Title:    Hospital Credentialing Specialist
Department:    Credentialing
Reports to:    Manager, Credentialing
FLSA Status:    Non-Exempt

PRACTICE OVERVIEW
Radiology Partners is the largest and fastest growing on-site radiology practice in the US. We are an innovative practice focused on transforming how radiologists provide consistently exceptional services to hospitals, imaging centers, referring physicians and patients. With our state-of-the art clinical technology, specialized expertise, access to capital, and retention of top physician talent, Radiology Partners reliably exceeds the expectations of our clients, patients, and partners. We serve our clients with an operational focus, and, above all, a commitment to quality patient care. Our mission is To Transform Radiology.

TEAM OVERVIEW
The Credentialing Specialist will be coming into the centralized verification office which is comprised of talented business office professionals with significant experience in developing and operating efficiently. The department is a great environment to learn and grow from and reflects the professional, energetic and collaborative culture of Radiology Partners.

POSITION SUMMARY
Radiology Partners is hiring a Credentialing Specialist. The position will report to a credentialing manager and will be focusing on processing and maintaining provider credentialing information for the entire business.

POSITION DUTIES AND RESPONSIBILITIES
•    Compiles and maintains current and accurate data for all providers
•    Completes provider credentialing and re-credentialing applications; monitors applications and follows-up as needed.
•    Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers
•    Maintains knowledge of hospital specific requirements for credentialing providers
•    Sets up and maintains provider information in online credentialing databases and systems
•    Tracks license and certification expirations for all providers to ensure timely renewals
•    Tracks license, DEA and professional liability expirations for appointed providers
•    Create and maintain Radiologist credentialing files
•    Research and obtain verifications of radiologist credentials
•    Coordinate with hospital/center and radiologists to complete credentialing process, including any additional documentation, verifications, references, and applications necessary
•    Complete and review all applications to ensure accuracy prior to submission

DESIRED PROFESSIONAL SKILLS AND EXPERIENCE
•    Experience in the healthcare industry is a must
•    1 — 2 years of experience in credentialing required
•    Ability to organize and prioritize work and manage multiple priorities
•    Excellent verbal and written communication skills including letters, memos, and emails
•    Excellent attention to detail
•    Ability to research and analyze data
•    Ability to work independently with minimal supervision
•    Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization
•    Knowledge and understanding of the credentialing process
•    Proficient use of Microsoft Office applications (Word, Excel) and internet resources

Please apply online at https://chu.tbe.taleo.net/chu01/ats/careers/v2/viewRequisition?org=RADIPART&cws=37&rid=1312 or send your resume directly to maria.hernandez@radpartners.com.