PHP Credentialing Specialist

Baptist Health strives to cultivate a close-knit, positive and professional environment that encourages our employees to want to come to work every day. When you choose Baptist, you have an opportunity to play a role in providing compassionate, quality care that makes a difference in the lives of our patients and promotes joy throughout our communities. Job Description: JOB DUTIES – Performs all aspects of the Credentialing and re-credentialing process and solicit pertinent information for committee review. Maintain individual physician/provider permanent file and record of decisions regarding participation. Compose and distribute monthly Cactus Payor Update to all network/payors contacts. Responsible for preparation and execution of annual delegated credentialing network/payor audits. Maintain provider relations and serve as the point of contact for all communication between a Payor and the individual physician offices that are members of the PHO. Staff Committee meetings to include scheduling meetings, recording minutes and maintain permanent record of related proceedings. Provide professional education and information for office managers and staff regarding local managed care issues and other changes in the market through the practice manager/staff meetings and Zoom meetings/webinars. Promotes good public relations for Purchase Health Partners (PHP). Serves as needed on committees. Assists the PHP Coordinator and AVP Networks and Collaboration with other duties as assigned. Follows Hospital and Departmental Policies and Procedures. QUALIFICATIONS AND ACCOUNTABILITY –A Bachelor’s degree is required with a minimum of 5 years’ experience in healthcare management pertaining to credentialing program, managed care, physician relations or a related field and proven communications and quantitative skills. Must have ability to prioritize multiple tasks and carry them through to completion in a timely, cost-effective manner. Supervised by the PHP Coordinator. The PHP Coordinator conducts performance evaluations at the end of the three-month probationary period. Evaluations, thereafter, are on a yearly basis. If you would like to be part of a growing family focused on supporting clinical excellence, teamwork and innovation, we urge you to apply now! Employees will be expected to comply with Baptist Health’s infectious disease and vaccination policies, which include but may not be limited to compliance with BHS’ mandatory vaccination policies for influenza and COVID unless reasonable accommodations are needed under applicable law Baptist Health is an Equal Employment Opportunity employer. Founded in 1924, Baptist Health has been bringing advanced medical technology, modern facilities, and many of the region's most prominent physicians and medical professionals to the communities of our commonwealth for nearly a century. Headquartered in Louisville, the Baptist Health family of hospitals, care centers, physician offices and health facilities has experienced tremendous growth in recent years. Counting all nine hospitals, we have more than 2,700 licensed beds. Baptist Health has more than 300 points of care include outpatient facilities which offer Urgent Care, occupational medicine, physical therapy and diagnostics. Home care is also available in 39 Kentucky counties, six counties in Illinois and six counties in Southern Indiana. Our physician network of more than 3,000 employed and affiliated physicians continues to grow as we endeavor to improve access to healthcare and enhance the health of Kentucky as a whole. EEO Statement: Baptist Health is an Equal Employment Opportunity employer, and seeks to employ individuals without regard to race, color, national origin, gender, sexual orientation, gender identity, age, disability, marital status, citizenship status, military status, religious or political beliefs, protected veteran status, employment status or any other protected class identified in any federal, state, or local law. Baptist Health specifically encourages minority, female, disabled, veteran and other candidates from diverse backgrounds to apply and strengthen our team. Please note that Baptist Health is a drug-free workplace and employment with Baptist Health is subject to post offer, pre-employment drug testing. NOTICE OF NONDISCRIMATION AND ACCESSIBILITY TO SERVICES Persons with hearing and speech impairments can contact Baptist Health facilities by using the Kentucky Relay Service, a toll-free telecommunication device for the deaf (TDD). For voice to TDD, call 800.648.6057. For TDD to voice, call 800.648.6056.