Credentialing Coordinator

Company: Dignity Health
Location: Bakersfield
Posted on: May 27, 2023

Job Description:

**Credentialing Coordinator**
Dignity Health Management ServicesBakersfield, California
The posted compensation range of $17.93 - $22.62 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law.
**Requisition ID** 2023-299629 **Employment Type** Full Time **Department** Credentialing **Hours/Pay Period** 80 **Shift** Day **Weekly Schedule** Monday - Friday (8:00am-5:00pm) **Remote** Yes **Category** Administrative and Clerical
**Overview**
The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Healths Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups hospitals health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.
Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options including medical dental and vision plans for the employee and their dependents Health Spending Account (HSA) Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.
**Responsibilities**
*****This position can be onsite or remote** **within California** **.**
**Position Summary:**
Assist with all credentialing activities associated with all IPAs and product lines managed by Dignity Health MSO. Works with Credentialing Supervisor, Medical Directors, Provider Relations Department, Contracting Department, health plans, providers, provider office staff, and other persons or businesses as necessary to ensure that all providers are properly credentialed according to NCQA and health plan standards. Where appropriate, makes recommendations regarding improvement of processes and procedures.
Responsibilities may include:
- Keep current on all NCQA and health plan credentialing standards, policies, and procedures.
- Maintain access to all Primary Source Verification websites.
- Assists with performing internal primary source verifications and full credentialing for those providers who are to be credentialed on a RUSH basis. RUSH status is to be determined by administration including CEO and Medical Directors.
- Keep all credentialing files and credentialing database current and complete.
- Attend assigned meetings pertaining to provider credentialing and provider network management as assigned, including but not limited to Provider Information Meetings sponsored by Provider Relations Department on a quarterly basis, QM & Credentialing Committee meeting for GEMCare Medical Group, and MasterCare IPA Board of Directors.
- Coordinate credentialing activities with Supervisor as needed, and keep supervisor informed of status of credentialing activities on a regular basis.
- Validate information in master credentialing database against information in health plan database.
- Perform other duties as assigned.
**Qualifications**
**Minimum Qualifications:**
- One to two (1-2) years of experience in the healthcare industry required, preferably with experience in credentialing.
- Excellent analytical and organizational skills required. Highly detail oriented, creative and proven problem solver. Strong attention to detail and ability to analyze same.
- Self-directed and able to work independently under tight time frames. Able to interact with co-workers, managers, supervisors, and administrators in a manner that promotes a positive work environment.
- Strong MS Office Suite skills (Word, Excel, PowerPoint and SharePoint) and proven ability to learn/use company specialized software and hardware.
**Preferred Qualifications:**
- One or more (1+) years of vocational or college coursework preferred. Bachelor's degree preferred.
- Prefer Certified Provider Credentialing Specialist certification (CPCS).
**Equal Opportunity**
CommonSpirit Health is an Equal Opportunity/Affirmative Action employer committed toa diverse and inclusive workforce. All qualified applicants will be considered foremployment without regard to race, color, religion, sex, sexual orientation, genderidentity, national origin, age, disability, marital status, parental status,ancestry, veteran status, genetic information, or any other characteristic protectedby law. For more information about your EEO rights as an applicant,pleaseclick here. (https://tbcdn.talentbrew.com/company/35300/img/v1_0/EEOC_KnowYourRightsEnglish.pdf)
CommonSpirit Health will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractors legal duty to furnish information. 41 CFR 60-1.35(c).External hires must pass a post-offer, pre-employment background check/drug screen. Qualified applicants with an arrest and/or conviction will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, ban the box laws, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.If you need a reasonable accommodation for any part of the employment process, please contact us by telephone at (415) 438-5575 and let us know the nature of your request. We will only respond to messages left that involve a request for a reasonable accommodation in the application process. We will accommodate the needs of any qualified candidate who requests a reasonable accommodation under the Americans with Disabilities Act (ADA).CommonSpirit Health participates in E-Verify.Dignity Health is an Equal Opportunity/ Affirmative Action employer committed to a diverse and inclusive workforce. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, marital status, parental status, ancestry, veteran status, genetic information, or any other characteristic protected by law.

Keywords: Dignity Health, Bakersfield , Credentialing Coordinator, Other , Bakersfield, California