PHP Credentialing Specialist

Baptist Health strives to cultivate a close-knit, positive and professional environment that encourages our employees to want to come to work every day.

When you choose Baptist, you have an opportunity to play a role in providing compassionate, quality care that makes a difference in the lives of our patients and promotes joy throughout our communities.

Job Description:

JOB DUTIES -

• Performs all aspects of the Credentialing and re-credentialing process and solicit pertinent information for committee review. Maintain individual physician/provider permanent file and record of decisions regarding participation.

• Compose and distribute monthly Cactus Payor Update to all network/payors contacts.

• Responsible for preparation and execution of annual delegated credentialing network/payor audits.

• Maintain provider relations and serve as the point of contact for all communication between a Payor and the individual physician offices that are members of the PHO.

• Staff Committee meetings to include scheduling meetings, recording minutes and maintain permanent record of related proceedings.

• Provide professional education and information for office managers and staff regarding local managed care issues and other changes in the market through the practice manager/staff meetings and Zoom meetings/webinars.

• Promotes good public relations for Purchase Health Partners (PHP).

• Serves as needed on committees.

• Assists the PHP Coordinator and AVP Networks and Collaboration with other duties as assigned.

• Follows Hospital and Departmental Policies and Procedures.

QUALIFICATIONS AND ACCOUNTABILITY -A Bachelor's degree is required with a minimum of 5 years' experience in healthcare management pertaining to credentialing program, managed care, physician relations or a related field and proven communications and quantitative skills. Must have ability to prioritize multiple tasks and carry them through to completion in a timely, cost-effective manner. Supervised by the PHP Coordinator. The PHP Coordinator conducts performance evaluations at the end of the three-month probationary period. Evaluations, thereafter, are on a yearly basis.

If you would like to be part of a growing family focused on supporting clinical excellence, teamwork and innovation, we urge you to apply now!

Employees will be expected to comply with Baptist Health's infectious disease and vaccination policies, which include but may not be limited to compliance with BHS' mandatory vaccination policies for influenza and COVID unless reasonable accommodations are needed under applicable law

Baptist Health is an Equal Employment Opportunity employer.