We are looking for a Credentialing Coordinator to join us in leading our organization forward.
McLaren Integrated HMO Group (MIG), a division of McLaren Health Care Corporation, is an organization with a culture of high performance and a mission to help people live healthier and more satisfying lives.
McLaren Health Plan and MDwise, Inc., subsidiaries of MIG, value the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plans can thrive. As an employee MIG, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members.
McLaren Health Plan is our Michigan-based health plan dedicated to meeting the health care needs of each of our Michigan members. Learn more about McLaren Health Plan at https://www.mclarenhealthplan.org
MDwise is our Indiana-based health plan, working with the State of Indiana and Centers for Medicare and Medicaid Services to bring you the Hoosier Healthwise and Healthy Indiana Plan health insurance programs. Learn more about MDwise, Inc. at https://www.mdwise.org/
Position Summary:
Credentialing Coordinator is responsible for developing and maintaining a system for the credentialing of the Plan' network delegates and providers. These functions include the responsibility of coordinating all credentialing activities on appointment and reappointment and providing resources to organizational entities. Responsible for meeting established provider credentialing timelines. Supports and coordinates credentialing activities with Provider Relations.
This position is fully remote.
Equal Opportunity Employer of Minorities/Females/Disabled/Veterans
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Qualifications:
Required:
Experience credentialing and recredentialing healthcare professional and facility providers.
Knowledge of credentialing standards, regulations, and best practices.
Experience with Medicare and Medicaid web-based enrollment applications.
Experience using Credentialing Software (i.e. Symplr Provider, CAQH, etc).
Strong attention to detail and excellent organizational skills.
Ability to prioritize tasks and meet deadlines in a fast-paced environment.
Excellent written and verbal communication skills.
High School diploma or equivalent (GED).
Four (4) years' experience in a credentialing or medical staff coordination role.
Preferred: Associate degree in business, health care or related field.
Current certification as Certified Professional Medical Staff Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS).
Previous experience in provider credentialing within a health plan and/or Medical Staff Services.
Knowledge of NCQA Credentialing Standards.
