Healthplan (Managed Care) Provider Credentialing Specialist
Orlando Health
Orlando, Florida
Be Moved
To a Career with a Central Florida Healthcare Leader
At Orlando Health, you can develop the healthcare career that is right for your individual goals. As a family of specialty and community hospitals, each has its own character, a natural extension of the specialized services offered. It is our mission that unifies us to offer superior service and provide quality healthcare to the people of Central Florida. We are currently hiring for the following position:
Healthplan (Managed Care) Provider Credentialing Specialist
Complete the review of all credentialing and recredentialing applications submitted to the Healthchoice health plan for inclusion in the provider network. Obtain timely and accurate primary source verifications for all credentialing and recredentialing activities. Present any findings in both verbal and written reports to the physician-led committees. Schedule, coordinate and oversee the successful completion of audits from both state regulatory agencies and entities who delegate health plan credentialing to Healthchoice. Assure compliance to state, regulatory and national accreditation standards. Maintain all credentialing and recredentialing files.
Candidates must have 3 years of managed care provider credentialing experience. A strong working knowledge of Microsoft Office and Access database and knowledge of Access query writing required. Must have demonstrated excellent organizational, verbal communication and interpersonal skills. Must be flexible to attend early morning meetings and comfortable with presenting to Medical Directors and other physicians. An Associates degree or equivalent years of experience may be substituted on a two-for-one basis. Must have certification by the National Association of Medical Staff Services, or be actively pursuing these requirements to achieve certification based on eligibility.
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