Health Specialist Jobs

About The Position

Requirements

• Bachelor's Degree Business, Communication, Human Resource Management, Related field
• 5 years experience in healthcare
• 2 years experience in project management, relationship management and/or organizational development
• Work independently, under minimal supervision and must possess the ability to manage across multiple projects simultaneously with critical thinking and independent judgement.
• Ability to communicate, interface and relate to groups on all professional levels.
• Must have above average analytical skills and ability to effectively prioritize competing priorities.
• Proficient with use of computer software and productivity tools to accomplish individual and project objectives.
• Excellent organizational skills and time management.
• Global understanding of organizational development, change management and process improvements, principles and processes.
• Superior oral and written communications skills.
• Creative problem-solving skills.

Nice To Haves

• Certified Professional Credentialing Specialist (CPCS_NAMSS) Certification through NAMSS within 2 Years Preferred
• Flexibility with non-traditional work hours and local travel.

Responsibilities

• Develops, executes, and maintains standard operating procedures and protocols for provider onboarding and enrollment.
• Supports Medical Group in delivering exceptional candidate, customer, and provider experience.
• Establishes and maintains collaborative partnerships with the medical group leaders; demonstrates strong conflict resolution skills to ensure policies and procedures are followed without compromising candidate experience or engagement.
• Collaborates across multiple organizational divisions including human resources, central business office, IT, marketing, operations, medical affairs and BMG finance to ensure seamless processes and timely start for providers.
• Builds relationships and delivers seamless onboarding experience with providers to support retention outcomes throughout his/her first year as well as building rapport to influence outcomes with other internal departments.
• Facilitates contract hand off with BMG finance – compensation manager – to ensure timely and accurate provider payments, including sign on bonuses, residency/fellowship stipends, and traditional payroll.
• Collects and submits all required information and documentation for provider (re)enrollment with government payors and contracted Managed Care plans.
• Facilitates and works with 3rd party vendor, Managed Care and Central Business Office on provider enrollment processes including, but not limit to, new provider enrollments, on-going requests for updated documentation, attestations, enrollment statusing and verification.
• Monitors enrollment tracking dashboard to ensure applications are being processed timely and provides any additional missing information as needed to complete enrollment.
• Communicates with internal stakeholders regarding status of enrollments.
• Audits providers information for accuracy according to the necessary information required by various business units for internal standards and regulatory requirements.
• Maintains complex databases and ensures confidential, complete and accurate data capture.