AdventHealth

Credentialing Specialist Managed Care -Remote


PayCompetitive
LocationMaitland/Florida
Employment typeFull-Time

This job is now closed

  • Job Description

      Req#: 24039066
      Employer Industry: Healthcare Services

      Why consider this job opportunity:
      - Benefits from day one, including mental health resources and career development
      - Opportunity for career advancement and professional growth within a supportive environment
      - Work remotely Monday through Friday, offering flexibility
      - Be part of a community that values wholeness and uplifts others in body, mind, and spirit
      - Contribute to a mission-driven organization focused on extending the Healing Ministry of Christ

      What to Expect (Job Responsibilities):
      - Coordinate, monitor, and maintain the credentialing and re-credentialing process for healthcare providers
      - Conduct thorough background investigations and primary source verifications of practitioner applications
      - Prepare credentialing files for presentation to the AHS Delegated Credentialing Committee and other related committees
      - Process requests for privileges and ensure compliance with outlined criteria
      - Respond to inquiries from healthcare organizations and assist with managed care delegated credentialing audits

      What is Required (Qualifications):
      - Experience with credentialing processes in a healthcare setting
      - Knowledge of regulatory bodies such as Joint Commission, NCQA, and CMS
      - Strong attention to detail and ability to maintain accurate records
      - Proficiency in using credentialing databases, such as MSOW/Apogee
      - Excellent communication skills for interfacing with internal and external customers

      How to Stand Out (Preferred Qualifications):
      - Familiarity with the National Practitioner Database and Health Care Quality Improvement Act
      - Previous experience conducting internal file audits related to credentialing

      #HealthcareServices #Credentialing #RemoteWork #CareerDevelopment #MissionDriven

      We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately.
      We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.
  • About the company

      AdventHealth is a Seventh-day Adventist non-profit health care system headquartered in Altamonte Springs, Florida, that operates facilities in 9 states across the United States.