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Quick Links to Job Listings
- Credentialing Specialist, Gemini Diversified Services, Inc., Fountain Valley, CA (Possible telecommute)
- Supervisor, Credentialing and Privileges, Kaiser Permanente, South San Francisco, CA
- Provider Relations / Enrollment Manager, MedAmerica, Emeryville, CA
Current Job Listings
Posted On April 4th, 2012
Credentialing Verification Organization (CVO) Seeking a F/T Credentialing Specialist
We are a fast-paced, fully automated/paperless Healthcare credentialing company seeking an experienced, knowledgeable Credentialing Specialist to process 75+ credentialing files per week for our MANAGED CARE (NCQA) clients. This position is full-time Monday through Friday, 40 hours per week. The first 90-days will require training and working in our Fountain Valley offices and upon 90-day completion, the opportunity to telecommute MAY be offered.
We utilize Cactus software and handle a high volume of files on a monthly basis. You must be a self-starter, dependable, motivated, and able to juggle many tasks and credentialing files at one time. Must have strong knowledge of NCQA Standards. A CPCS certification is a plus, and preferred. We work paperless, utilizing two monitors and Adobe Acrobat, so your experience in a paperless environment is a huge plus.
Responsibilities will include:
• Processing incoming applications for initial credentialing and recredentialing by reviewing applications for completeness with follow-up for missing information
• Data entry of all practitioner information into our credentialing database
• Performing primary source verification requests through written/faxed/ telephone requests to meet the applicable standards (licensure, education & training, etc.)
• High level of customer service and day-to-day support provided to our clients assigned to Specialist
• Additional duties, as assigned
We offer a medical/dental/vision insurance plan, paid vacation, flexible hours, and an excellent team of people to work with!
If you feel your qualifications meet our requirements and would like to apply, please fax your resume with salary requirements to 714-782-5580 Attn: Craig Rizzi, CPCS, or email crizzi@servicesbygemini.com. No phone calls please.
Posted On March 24th, 2012
Health is our business
Make it yours. At Kaiser Permanente, we realize that it takes more than expert medical care to be one of the nation’s leading health care providers and not-for-profit health plans. It takes advanced technologies, state-of-art facilities, and the people to support them. Come impact your future, and the future of care. Join us in South San Francisco, California.
In this role, you will be a member of the Quality Outcomes Management Team and will be responsible for directing the medical staff services program that includes credentialing and privileging and medical staff business affairs as well as working closely with all of the hospital-based medical services, committees, individuals, and outside regulatory agencies.
Qualifications include:
• Four years of experience in a hospital setting with at least two years of supervisory experience
• Experience in word processing, MIDAS, and data base management
• Experience with medical staff functions
• Previous experience with CALS accreditation survey process
• A bachelor’s degree in Health Science or equivalent experience preferred
• CPCS (Certified Provider Credentialing Specialist) and/or CPMSM (Certified Professional Medical Services Management) preferred
• Participation in NCQA and The Joint Commission accreditation process
• Training in principles and tools of TQM/CQI
• Knowledge of credentialing and privileging
• Excellent written and verbal communication skills, organizational skills, and strong interpersonal skills
• The ability to work in a Labor/Management Partnership environment
We offer a highly competitive salary and an exceptional benefits package. For immediate consideration, please visit http://jobs.kp.org for complete qualifications and job submission details, referencing job number 079079. You may also call Shannon Kelly at 925-229-7694. Principals only. EOE/AA Employer.
If you would like to hear the Kaiser Permanente story as told by our employees, watch the videos at kp.org/jobs/video. Follow us on twitter.com/KPCareers or visit the KP Careers tab on facebook.com/KPThrive.
This position supports Kaiser Permanente’s code of conduct and compliance by adhering to all laws and regulations, accreditation and licensure requirements, and internal policies and procedures.
jobs.kp.org
Posted On January 31st, 2012
MedAmerica is a physician practice management company providing business and consulting services to several clients, including one of the premier emergency medicine groups in multiple states.
The Provider Relations / Enrollment Manager is responsible for the daily operations of the Provider Enrollment Department. The ideal candidate will have 3-5 years of experience in credentialing and/or provider enrollment in a healthcare setting. The position requires superb communication skills, a mature grasp of organizational hierarchy, ability to prioritize tasks and projects and the discretion to know when to act independently and when to ask for guidance and/or assistance. This job is vital to the success of our clients and demands flexibility, a customer-focus, organization and a passion for details. The ideal candidate will engage in teamwork functions supporting and cooperating with team members to help keep up to date on changes in the provider enrollment field.
Minimum Qualifications:
A. 3-5 years working with government payors, physicians, and direct provider enrollment experience required. Managed care or billing background preferred. College degree required.
B. 5 years management experience with supervising a department with multiple staff members.
C. Excellent writing and presentation skills.
D. Good organizational and project management ability.
E. Ability to review managed care contracts and interpret payor regulations.
F. Successfully able to navigate payor issues and facilitate issue resolution.
G. High level of discernment, autonomy, and independent decision-making.
H. Ability to understand business structures and how this impacts provider enrollment.
I. Responsible for reviewing licensing, payor enrollment and regulations for new contracts.
J. Proven ability to communicate with executives.
K. Ability to identify opportunities for automation and using systems to integrate processes.
Why work with MedAmerica?
For the sixth year in a row, MedAmerica’s employees voted us a "Best Place to Work in the Bay Area.” We are located in the beautiful Watergate Towers complex in Emeryville overlooking the San Francisco Bay and offer a friendly, stimulating, and business casual work atmosphere. We offer a benefits package that is competitive with some of the best companies in the Bay Area. Our benefits include: complimentary fitness center, dependent care plan, medical flexible spending account, 401K program (including a very generous company match), medical, dental, vision, prescription, long term disability, and life insurance.
If you are interested in this position please email your resume with a cover letter to
recruiting@medamerica.com. Please type “PE Manager – Your Name” in the subject line. Fax (510) 879-9080
MedAmerica is an Equal Opportunity Employer.
www.MedAmerica.com