HP Credentialing - CME Spec

Essential Duties and Responsibilities

• Maintains utmost level of confidentiality at all times.
• Adheres to DHS/DHP policies and procedures.
• Demonstrates business practices and personal actions that are ethical and adhere to corporate compliance and integrity guidelines.
• Processes applications for credentialing and recredentialing.
• Processes requests for temporary privileges.
• Prepares confidential correspondence.
• Oversees and maintains the credentialing database program.
• Maintains all credentials files.
• Prepares credentialing profiles.
• Monitors database for expiration of required credentials, securing current verification of licensure, DEA, and professional liability insurance.
• Monitors state and federal sanctions reports.
• Oversight of all provider data to be published in provider directories and GeoAccess prepared provider maps.
• Other duties as needed to support business operations.

Education and/or Experience

• A high school diploma or general education degree (GED).
• Three to five years related experience and/or training.
• Or equivalent combination of education and experience.
• Credentialing and/or Health Plan/HMO experience is preferred.