Job Description:

The Credentialing and Contracting Admin Specialist is responsible for facilitating Select Health’s credentials verification program as well as facilitating the development and execution of professional participating provider services agreements (PPSA), amendments, and terminations.

Job Description

The Credentialing and Contracting Admin Specialist will facilitate all aspects of the credentials verification program with accuracy and attention to detail. In addition, this position contributes to the oversight and management of provider contracts for Select Health and serves as a liaison between Select Health and affiliated providers.

The Credentialing and Contracting Admin Specialist is responsible for the following:

Processing initial credentialing and re-credentialing applications.Capturing primary source documentation in computer databases.Preparing records and applications to be reviewed by the Select Health Credentialing Committee.Maintaining reports of credentialing activities such as accreditation, membership, or facility privileges.Ensuring applications comply with applicable laws, regulations, procedures and policies.Monitoring credentialing data between credentialing and re-credentialing cycles. Remaining informed of any changes to credentialing guidelines.Creating and sending contracts and amendments using legal-approved templates.Coordinating the execution of contracts with the respective Select Health leadership and providers.Collaborating with internal Select Health departments to ensure accurate and current information regarding provider contract status is updated appropriately in all internal systems.Preparing notices to terminate and rescind contracts.Assisting providers and internal Select Health departments in resolving contract-related inquiries.Drafting language to address changes and unique situations for review by Select Health leadership.Supporting the maintenance of accurate records for all contracts and associated documentation, ensuring data integrity and accessibility.Communicating information regarding contract changes to the appropriate departments.Maintaining a broad understanding of provider contract agreements.

The Credentialing and Contracting Admin Specialist will have frequent contact with system wide medical staff services professionals, administrators and/or medical directors, legal department, and providers.

The Contracting and Contracting Admin Specialist must keep the Provider Development leadership apprised of problems or concerns and perform other work-related duties as assigned.

Required Qualifications

Associate degree. Education must be obtained through an accredited institution. Degree will be verified.

-or-

Three years of experience in a healthcare-related industry.

Experience working in the medical field in an administrative or support role.Demonstrated ability to establish and maintain effective working relationships with office administrators, corporate personnel, and providers.Effective verbal and written communication skills and the ability to work well with a team.Knowledge of computer technology is needed to perform job functions.Intermediate level experience with Word, Excel, Adobe, and OneNote.Must be comfortable learning a sophisticated database program.Demonstrated workload management/prioritization skills.Demonstrated ability to work through frequent interruptions, solve problems, make decisions, and possess excellent organization skills.The incumbent must be able to work with a variety of healthcare professionals, function with minimal supervision, be self-motivated, and maintain confidentiality.

Preferred Qualifications

Knowledge of Salesforce.Knowledge of CAQH.Knowledge of PeopleSoft.Knowledge of Adobe Sign and/or DocuSign. Bachelor’s degree. Education must be obtained through an accredited institution. Degree will be verified.Certified Provider Credentialing Specialist (CPCS) by NAMSS.Certified Professional Medical Services Management (CPMSM) by NAMSS.Paralegal training or experience.

Skills

Provider CredentialingTeamworkWritten and Verbal CommunicationAttention to DetailProblem SolvingDecision MakingComputer TechnologyOrganizational skillsAnalytical skillsNCQA Standards

Physical Requirements:

Physical Requirements

Interact with others requiring the employee to communicate information.Operate computers and other office equipment requiring the ability to move fingers and hands.See and read computer monitors and documents.Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment.

Location:

SelectHealth - Murray

Work City:

Murray

Work State:

Utah

Scheduled Weekly Hours:

40

The hourly range for this position is listed below. Actual hourly rate dependent upon experience. 

$23.30 - $35.48

We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Learn more about our comprehensive benefits packages for our Idaho, Nevada, and Utah based caregivers, and for our Colorado and Montana based caregivers.

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

All positions subject to close without notice.