Credentialing Specialist

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POSITION SUMMARY:

Credentialing Specialist is responsible for supporting the JHACH practitioners as outlined in the Medical Staff Bylaws, policies, delegated plans and related contracts in all credentialing, privileging and enrollment functions. Knowledge of accrediting and regulatory agencies i.e. TJC, NCQA, CMS, URAC and state regulations. Responsible for all practitioner credentialing, privileging and enrollment related functions including completion in timely manner. Handles sensitive information and peer protected data with the highest degree of confidentiality, security and sensitivity.

Hours: Full Time, Day Shift, 40 Hours Per Week

Location: St. Petersburg, FL

KEY ACCOUNTABILITIES:

1. Completes practitioner initial credentialing and re-credentialing applications focused on accurately, timely completion
2. Maintains accurate and up to date files for credentialed, privileged and/or enrolled practitioners in the Morrissey (MSOW) and Apogee software system
3. Completes initial and re-credentialing applications for external facilities for which JHACH contracts for specialty physicians to provide care
4. Ensures compliance with delegated plan agreements, delegated policies and procedures
5. Enters and updates data in the CAQH systems
6. Knowledge of federal and state regulatory requirements and accrediting body requirements, acquires including Joint Commission, NCQA, URAC and CMS

QUALIFICATIONS:

• Associates Degree in a related field; or, High School Diploma and four years related experience
• Minimum of 2 years' experience in hospital or managed care setting
• Proficiency skills in Microsoft applications Word, Excel, Power Point and Outlook
• Excellent writing, grammar, spelling and communication skills
• Knowledge of Morrissey or other credentialing software system(s)

Salary Range: Minimum 20.62/hour - Maximum 32.99/hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility. In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority.

We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices.

Johns Hopkins Health System and its affiliates are drug-free workplace employers.