POSITIONSUMMARY:

Responsible for supporting the JHACH practitioners as outlined in the Medical Staff Bylaws policies delegated plans and related contracts in all credentialing privileging and enrollment functions. Ensures ongoing compliance with the accrediting and regulatory agencies i.e. TJC NCQACMSURAC and state regulations. Works under minimal supervision specifically with the Medical StaffServicesthe Managed Care Department and the Billing Department on issues and processes which directly impact practitioner credentialing privileging and payer enrollment. Immediate responsibility for all practitioner credentialing privileging and enrollment related functionsincludingcompletion in timely manner. Handles sensitive information and peer protected data with the highest degree of confidentiality security and sensitivity.

Hours: Full Time/40 Hours Per Week

Work Setting: Hybrid

Shift: Flexible Monday-Friday.

Location: St. Petersburg FL

KEYACCOUNTABILITIES:

1. Responsible for all duties associated with the practitioner initial credentialing and re-credentialingprocessfocused on accurately timely completion to ensure expedient medical staff and enrollmentcredentialing
2. Maintains accurate and up to date files for credentialed privileged and/or enrolled practitioners in theMorrissey(MSOW) and Apogee softwaresystem
3. Completes initial andre-credentialingapplications for external facilities for which JHACH contracts for specialty physicians to provide care
4. Maintains and applies advanced knowledge of accreditation and regulatory standards related to the medicalstaffcredentialingenrollmentdelegated credentialing delegated agreements privileging peer reviewfunctions
5. Prepare and present medical staff credentialing files to the Standards &Credentials Committee andenrollmentcredentialing files to the Delegated CredentialingCommittee
6. Follows-up and resolves payer denials related to enrollment credentialing and works with ManagedCareDepartment to monitor and resolve third party billing and complianceissues
7. Ensures compliance with delegated plan agreements delegated policies and procedures including submissionofmonthly quarterly and yearlyroster
8. Coordinates the process for obtaining certificates of insurance from the Risk Department for newpractitionersprior to hiredate
9. Works independently and in a team based collaborative environment; prioritize and implement multipleprojects

QUALIFICATIONS:

• Associates Degree in a relatedfield
• Minimum 4 years experience in hospital or managed care credentialingsetting
• Certified Professional Medical Services Management (CPMSM) and/or Certified ProviderCredentialingSpecialist(CPCS) preferred
• Advanced skills in Microsoft applications Word Excel Power Point andOutlook
• Excellent writing grammar spelling and communicationskills

Salary Range: Minimum 22.68/hour - Maximum 36.29/ will be commensurate with equity and experience for roles of similar scope and responsibility.

In cases where the range is displayed as a $0 amount salary discussions will occur during candidate screening calls before any subsequent compensation discussion is held between the candidate and any hiring authority.

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Diversity and Inclusion are Johns Hopkins Medicine Core Values. We are committed to creating a welcoming and inclusive environment where we embrace and celebrate our differences where all employees feel valued contribute to our mission of serving the community and engage in equitable healthcare delivery and workforce practices.

Johns HopkinsHealth Systemand its affiliatesare an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity and expression age national origin mental or physical disability genetic information veteran status or any other status protected by federal state or local law.

Johns Hopkins Health System and its affiliates are drug-free workplace employers.