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JOB
OPPORTUNITIES:
Post your Position
Openings here!
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HCA Orange Park Shared Services
Reporting to the Assistant Chief Operating Officer, this position will lead the development and management of a regional Credentials Processing Center (CPC). This position works closely with HCA's quality department, shared services, and other company leaders to implement HCA's credentialing initiative. The Director will be responsible for ensuring a timely, effective credentialing process for iitial appointments, reappointments, and privileging for select HCA hospitals within established service levels.
Debra Dennis
ddennis@missionsearchusa.com
(800) 410-2009 Ext. 239
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Delray Medical Center
Delray Beach, FL
Credentialing Specialist Responsible for maintaining ECHO credentialing database for Medical Staff and Allied Health Professional staff. Responsible for tracking of expirable documents and all reports associated with Medical Staff functions. Assist in distribution and receipt of pre-applications, applications for initial appointment and reappointment to the Medical and Allied Health Professional staff. Collect and maintain accurate records of Medical Staff dues and application fees. Maintain confidentiality of records at all times.
Mitzi G. Gorman, CPCS, CPMSM
Mitzi.Gorman@tenethealth.com
561-495-3299
Delray Medical Center
ATTN: Medical Staff Office
5352 Linton Blvd.
Delray Beach, FL 33484
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Delray Medical Center
Delray Beach, FL
Medical Staff Coordinator Medical Staff Coordinator for approximately 500 Medical Staff/Allied Health Professionals in the Tenet Healthcare Organization. Working in an office with one additional Medical Staff Coordinator, one Credentialing Specialist, one Medical Staff Office Coordinator, and under the direction of the Director of Medical Staff Office. Responsible for primary source verification of applicants for reappointment and Allied Health Professional initial appointment.
Mitzi G. Gorman, CPCS, CPMSM
Mitzi.Gorman@tenethealth.com
561-495-3299
Delray Medical Center
5352 Linton Blvd.
Delray Beach, FL 33484
Fax: 561-495-3202
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HCA Shared Services Division
This position will be responsible for supporting the development and implementation of the Credentialing Processing Center policies and procedures. This will include, but not be limited to responsibility for credentialing new and established health care providers, and maintenance of information to include primary source verification, follow up, data collection, data entry, and document review. Excellent communication and relationship building skills are required. Will be expected to assist the Manager and Director with other tasks/projects as requested. All activities will be performed for select HCA hospitals within established levels. Compliance with HMA policy and procedure, Federal and State regulatory and accrediting agencies is required.
Qualification Requirements
EDUCATION
Associate degree or an equivalent combination of education and experience required. Bachelor Degree preferred.
EXPERIENCE
Minimum one-year experience preferred in healthcare credentialing (i.e., healthcare facility, managed care setting, credentials verification organization, or Medical Staff Office)
Experience with Credentialing Accreditation by Joint Commission or National Committee for Quality Assurance preferred
Demonstrated working knowledge of the health care and credentialing industry, including medical-legal issues and laws, regulatory agencies, and other national standards preferred
Completion of post Cactus training testing of 90% or greater
Understanding of professional telephone etiquette
Able to work with minimal supervision and works well in both individual and group environment
CERTIFICATE/LICENSE - NAMSS certified at CPCS level preferred, or a commitment to pursue certification within one year Buffy Bradley
buffy.bradley@hcahealthcare.com
(615) 886-5355
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HCA Shared Services Division
The Manager of Credentialing Shared Services in the Shared Services Division (SSD) should possess a strong background in data analysis and credentialing. This includes proactively identifying issues, coordinating issue resolution, and monitoring events to determine educational opportunities. This also involves monitoring performance to identify best practices and working with the SSD AVP Credentialing Shared Services to implement these across the operations. Additionally, this includes developing applicable credentialing policies and procedures and providing input related to Cactus credentialing system. This individual will play a key role in linking operations and systems (working closely with IT&S) in that these functions must be in sync in terms of compliance parameters. This individual is a liaison between the SSD, applicable HCA Corporate Departments (e.g., Legal, Quality Standards, and Information Technology & Services), and CPC personnel regarding credentialing issues.
They will participate in Internal Audit and QRS processes (program development, resolution of issues, etc.) related to compliance in the CPCs and will work with the CPCs to address identified issues. This individual must demonstrate strong commitment to stakeholder relationships by taking ownership of issues and facilitating effective outcomes in a timely manner.
Requirements:
EDUCATION
Advanced education or equivalent work experience.
EXPERIENCE
Minimum 3 years experience in credentialing or data analysis
Experience with hospital credentialing strongly preferred
CERTIFICATE/LICENSE - NAMSS certified CPCS level preferred
Buffy Bradley
buffy.bradley@hcahealthcare.com
(615) 886-5355
Cogent Healthcare
- Monthly monitoring and updating of expired documents;
- Physician screening (NPDB/AMA queries and primary source verification, if necessary);
- Track shipments (received/returned);
- Apply for provider NPI numbers, as applicable.
- Physician/Client/Internal communication;
- Data entry and documentation and tracking of all steps taken, including, provider numbers, effective dates, and correspondence received;
- Basic clerical functions including faxing, copying, and filing.
- Work with multiple hospitals to obtain payer mix and insurance contact information;
- Contact hospitals and payers to obtain applications and contracts via phone or websites, determine which applications/contracts apply to Hospitalist Care;
- Populate applications and documents with physician specific information and prepare for review and signature of provider;
- Determine who the signer should be and send app's/contracts for signature;
- Timely follow up on pending credentialing issues;
- Other duties as assigned.
Dawn Wilson
Wilson.Dawn@cogenthealthcare.com
(615) 377-5670
5410 Maryland Way, Suite 300
Brentwood, TN 37027
North Florida Regional Medical Center
Gainesville, FL
DIRECTOR MEDICAL STAFF SERVICES
North Florida Regional Medical Center (NFRMC) currently has an opening for a Director Medical Staff Services. As Director you will have an opportunity to work directly with a former NAMSS Golden Key Award nominee and one of the best in the profession prior to her retirement. The person in this position will serve in a management position, serving as an essential link between senior management and the medical staff, ensure compliance with state and federal statutes, accrediting and regulatory agencies related to the Medical Staff Office, oversee the credentialing of Allied/Medical Health professionals. Duties will consist of all activities involved in the credentialing function.
The successful candidate should possess excellent communication and administrative support skills, as well as the ability to coordinate several activities and prioritize work to accomplish optimal efficiency. The Director Medical Staff Services must be able to function calmly and effectively in high-pressure, stressful situations. This candidate must respect and maintain a high level of confidentiality, requiring a high degree of factual dependability.
EDUCATION/EXPERIENCE: The ideal applicant for this position must possess a minimum of three (3) years experience in the medical staff services and credentialing profession. The candidate should currently hold certification through NAMSS of either the CPCS or CPMSM, as well as having obtained an Associate or Bachelors degree. Familiarity with various state, federal and regulatory standards that impact the activities of the medical staff and credentialing processes is imperative.
Interested candidates meeting the above stated qualification may apply via the NFRMC website - www.nfrmc.com. NFRMC is an Equal Opportunity Employerstandards that impact the activities of the medical staff and credentialing processes is imperative.
Jodi Matts
(352) 333-4112
North Florida Regional Medical Center
6500 W. Newberry Road
Gainesville, FL 32605
Superior Health Plan, a subsidiary of the Centene
San Antonio, TX market
Case Manager I
Managed care experience, neo surg and adult critical care required. Interqual and CCM preferred. Current TX RN license required.
Centene Corporation is a publicly traded (NYSE: CNC) leading multi-line healthcare enterprise that provides programs and related services to individuals receiving benefits under Medicaid, including Supplemental Security Income (SSI) and the State Children's Health Insurance Program (SCHIP).
We offer our team members a comprehensive total rewards package including competitive pay with bonus potential plus medical, dental, vision, life, and disability insurance. Employees also can participate in our 401(k) program with matching benefit, tuition reimbursement and receive paid vacation, sick and personal leave plus 12 paid holidays annually. Centene also offers its employees a business casual work environment and Monday-Friday work schedules. Learn more at www.centene.com
Maria Nguyen
mnguyen@centene.com
Superior Health Plan
Austin, TX market
Case Manager I / Concurrent Review Nurse
At least 3 years recent clinical nursing experience in an acute care setting particularly in pediatrics, obstetrics or NICU (STRONGLY PREFERRED). One year of manager care experience preferred. RN required. Current state nursing license and driver's license.
Centene Corporation is a publicly traded (NYSE: CNC) leading multi-line healthcare enterprise that provides programs and related services to individuals receiving benefits under Medicaid, including Supplemental Security Income (SSI) and the State Children's Health Insurance Program (SCHIP).
We offer our team members a comprehensive total rewards package including competitive pay with bonus potential plus medical, dental, vision, life, and disability insurance. Employees also can participate in our 401(k) program with matching benefit, tuition reimbursement and receive paid vacation, sick and personal leave plus 12 paid holidays annually. Centene also offers its employees a business casual work environment and Monday-Friday work schedules. Learn more at www.centene.com
Maria Nguyen
mnguyen@centene.com
Superior Health Plan
Austin, TX market
Credentialing Manager
Superior Health Plan, a subsidiary of the Centene Corporation, is seeking a Credentialing Manager in our Austin, TX market.
Minimum of 2 years experience in Credentialing and working with healthcare providers in a managed care or insurance environment. Equivalent to a 4 year college education. Management experience is highly preferred. CPCS certification preferred Centene Corporation is a publicly traded (NYSE: CNC) leading multi-line healthcare enterprise that provides programs and related services to individuals receiving benefits under Medicaid, including Supplemental Security Income (SSI) and the State Children's Health Insurance Program (SCHIP).
We offer our team members a comprehensive total rewards package including competitive pay with bonus potential plus medical, dental, vision, life, and disability insurance. Employees also can participate in our 401(k) program with matching benefit, tuition reimbursement and receive paid vacation, sick and personal leave plus 12 paid holidays annually. Centene also offers its employees a business casual work environment and Monday-Friday work schedules.
Maria Nguyen
mnguyen@cenete.com
Phy Data, LLC
Credentialing Coordinator
To ensure all providers have privileges at facilities where they are working, are enrolled in various managed care organizations, are enrolled with Medicare & Medicaid programs, and are enrolled with all contracted payors. To support providers in obtaining necessary documentation for continuing medical education credits, state
license(s), DEA, and all related credentialing and contracting requirements.
Joy Sweeney
Joy.sweeney@phydata.com
Fax: 615.239.2036
Phy Data, LLC
3024 Business Park Circle
Goodlettsville, TN 37072
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