HP Credentialing - CME Spec

Where compassion meets innovation and technology and our employees are family.

Thank you for your interest in joining our team! Please review the job information below.

Essential Duties and Responsibilities:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. This job description is not intended to be all-inclusive; employees will perform other reasonably related business duties as assigned by the immediate supervisor and/or health plan administration as required.

• Maintains utmost level of confidentiality at all times.
• Adheres to DHS/DHP policies and procedures.
• Demonstrates business practices and personal actions that are ethical and adhere to corporate compliance and integrity guidelines.
• Processes applications for credentialing and recredentialing.
• Processes requests for temporary privileges.
• Prepares confidential correspondence.
• Oversees and maintains the credentialing database program.
• Maintains all credentials files.
• Prepares credentialing profiles.
• Monitors database for expiration of required credentials, securing current verification of licensure, DEA, and professional liability insurance.
• Monitors state and federal sanctions reports.
• Oversight of all provider data to be published in provider directories and GeoAccess prepared provider maps.
• Other duties as needed to support business operations.
  
  
  

Education and/or Experience:

• High school diploma or general education degree (GED); or three to five years related experience and/or training; or equivalent combination of education and experience.
• Credentialing and/or Health Plan/HMO experience is preferred.