All the benefits and perks you need for you and your family:
· Benefits from Day One
· Career Development
· Whole Person Wellbeing Resources
· Mental Health Resources and Support
Our promise to you:
Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
Shift: Monday-Friday
Job Location: Remote
The role you’ll contribute:
Under limited supervision, oversees the operations of the AdventHealth provider Multi state and Florida
Government enrollment/credentialing functions to develop, manage and monitor processes and
procedures that support the Government credentialing, re-credentialing and Expirable data
management.
Responsible for managing the government Multi state and Florida Government enrollment/credentialing
team.Functions include applications and Multi state and Florida Government credentialing services for
various physician groups and specialties for which government and contracting services are provided.
This position ensures all Multi state and Florida Government enrollment systems are current, accurate
and contracting information is disseminated to the appropriate persons.Manages the auditing and data
analysis for all Multi state and Florida Government credentialing files, documents, and ensures
correctness/completeness of data.Responsible for supporting Network Management/MSOW, MD Staff
and EPIC applications (or any other necessary application) to generate reports necessary to ensure
accuracy of provider records.Actively participates in outstanding customer service and accepts
responsibility in maintaining relationships that are equally respectful to all.
The value you’ll bring to the team:
PRINCIPAL DUTIES AND JOB RESPONSIBILITIES:
SYSTEMS - 15%
·Responsible for supporting management and functionality of Network Management, MD staff and EPIC (or any subsequent Government credentialing database).
·Manages Network Management database application, MD staff and EPIC (or any subsequent Multi state and Florida Government credentialing database) and Multi state and Florida Government enrollment system and related standard operating procedures to ensure physician information is complete, accurate, and up to date and holds team members accountable for accuracy, integrity of data and timeliness.
COMMUNICATION - 10%
·Communicates with provider office staff and practice management regarding the status of applications, additional materials required, etc.
·Educates provider and provider leadership staff on necessary documentation needed to enroll provider with appropriate payers.
SUPPORT - 15%
·Supports Director of Credentialing/Operations, Provider Enrollment/Quality Audit ManagerManager Revenue Management by resolving problems, questions, and issues while making sound decisions within the Managed Care enrollment team as well as for the payers and the practices.
·Supports physician contracting and Multi state and Florida Government credentialing services by auditing and analyzing data, verifying applications, preparing amendment letters, ensuring provider enrollment materials are processed efficiently and professionally.
·Supports the Negotiators through notification of current application status and new contract requirements.
LIAISON - 5%
·Acts as provider relations’ representative to medical groups to assist with operational and payment issues, as appropriate.
·Represents Sen Director of Credentialing/Operations, Provider Enrollment/Quality Audit Managerand Manager Revenue Management in various internal and external meetings
INFORMATION - 15%
·Coordinates process with Negotiators to ensure contracts are in place prior to sending applications to payer.
Manage provider enrollment team resources and workflow to reach maximum efficiency and productivity levels, as well as provide solutions on how to improve in this area.
DEVELOPMENT, EDUCATION & TRAINING - 5%
·Responsible for ensuring team is appropriately trained in all aspects of their job responsibilities.
·Takes the initiative to seek out education and training experience when there is a need and to stay informed of changes in the field of managed care and the objectives of the department.
·Leads or facilitates in education to Senior Management or staff at AHS medical groups as requested.
·Displays a willingness to grow and develop skills required to better perform his/her job.
·Completes assigned tasks in the appropriate time frame and holds direct reports
accountable for meeting deadlines and performance standards.Maintains an acceptable
work pace.
·In group situations, effectively contributes to the overall completion of work product according to the applicable directive and deadline.
Qualifications
The expertise and experiences you’ll need to succeed:
KNOWLEDGE AND SKILLS REQUIRED:
·Demonstrated skill and understanding of the PECOS system
·Ability to make administrative/procedural decisions and judgments.
·Ability to investigate and analyze information and draw conclusions.
·Ability to develop and deliver presentations.
·Ability to process computer data and to format and generate reports.
·Ability to supervise and train employees, to include organizing, prioritizing, and scheduling work assignments.
·Ability to communicate effectively, both orally and in writing.
·Ability to foster a cooperative work environment.
·Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies in a diverse community.
·Skill in developing policy and procedure documentation.
·Database management skills.
·Employee development and performance management skills.
·Knowledge of related accreditation and certification requirements.
·Knowledge of medical staff policies, regulations, and bylaws and the legal environment within which they operate.
KNOWLEDGE AND SKILLS PREFERRED:
·MSOW/Network Management
·EPIC
·MD Staff
·Proficient in MS Office (Excel, Word, Outlook)
EDUCATION AND EXPERIENCE REQUIRED:
·High School Diploma or GED
·Five years of healthcare experience, preferably in managed care, patient financial services, or provider relations
EDUCATION AND EXPERIENCE PREFERRED:
·5 years healthcare managerial experience.
LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:
·NAMSS Certification as a Certified Professional Medical Services Manager (CPMSM) or Certified Provider Credentials Specialist (CPCS) or actively pursuing certification and secure within 1 year of hire.
LICENSURE, CERTIFICATION OR REGISTRATION PREFERRED:
·Certified with Morrisey/MSOW/Apogee
·Certified in EPIC
·Certified in MD Staff
SUPERVISORY RESPONSIBILITIES
·Yes, supervises others.
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.
At AdventHealth, Extending the Healing Ministry of Christ is our mission. It calls us to be His hands and feet in helping people feel whole. Our story is one of hope — one that strives to heal and restore the body, mind and spirit. Our more than 80,000 skilled and compassionate caregivers in hospitals, physician practices, outpatient clinics, urgent care centers, skilled nursing facilities, home health agencies and hospice centers are committed to providing individualized, wholistic care.