Acts as key point of contact for the processing of enrollment applications for all providers. Works with System Credentialing and local medical staff contacts. Responsible for completing the ongoing review and attestation of all Munson Healthcare provider enrollment records.
Munson Healthcare is northern Michigan’s largest healthcare system, with eight award-winning community hospitals serving over half a million residents.
Lead and supervise credentialing support staff, ensuring quality, accuracy, and timely processing of credentialing and enrollment tasks.
Oversee provider credentialing, licensure, and internal enrollment with Medicare, Medicaid, Managed Care, and Commercial Plans.
Maintain provider rosters, monitor license and certification renewals, and ensure compliance with regulatory and internal standards.
At Better Life Partners, we provide what it takes to heal from addiction. Wherever. Whenever. By combining virtual and in-person counseling, community support, and medication access.
The Provider Enrollment Specialist is responsible for timely and effectively enrolling practitioners in health plans. The Specialist will monitor progress, ensure timeliness of enrollment completion, and provide updates. The Specialist will maintain accurate provider profiles in IntelliCred and CAQH.
Pediatrix Medical Group is one of the nation’s leading providers of specialized health care for women, babies and children since 1979.
Facilitate all aspects of required medical licensure for clinical personnel.
Drive the licensing process in a proactive, organized and streamlined manner.
Collaborate with credentialing, onboarding, and clinical teams.
Talkiatry is a national mental health practice co-founded by a patient and a triple-board-certified psychiatrist. They provide patients with the care they need and allow psychiatrists to focus on medicine with innovative technology and a human-centered philosophy.
Establish and maintain licensing processes for Physicians, Nurses, and Licensed Mental Health providers.
Monitor progress and approval of submitted licenses ensuring timely completion.
Serve as the primary point of contact for all matters related to licensing.
TimelyCare provides virtual medical and mental health support. They foster a supportive team culture with a mission-driven purpose and are an equal opportunity employer.
Lead and oversee Prior Authorization Operations across all lines of business.
Manage Prior Authorization processes ensuring optimal efficiency and compliance.
Drive cross-functional collaboration to align with organizational goals.
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans. They are rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve.
Ensuring providers are credentialed in a timely manner by monitoring the submission process.
Monitoring submission processes, updating protocols, and managing Virtual Assistants/BPO.
Communicating with payors and conducting regular reviews to validate internal credentialing data.
Grow Therapy aims to be the trusted partner for therapists growing their practice, and patients accessing high-quality care. They are a three-sided marketplace that empowers providers, augments insurance payors, and serves patients and have empowered more than ten thousand therapists.
Conduct research and analysis to develop factsheets, issue briefs and other educational resources.
Attend relevant briefing and seminars, providing support for webinars.
Assist with committee and partner meetings.
The American Public Health Association aims to influence public policy at all levels of government and within the private sector, and to serve as a catalyst for positive change. They create innovative, analytical and informative resources on a range of public health disciplines and topics.
Manages client denials and concerns through analytic review of clinical documentation.
Delivers final determination based on skillsets and partnerships with Humana parties.
Investigates and resolves member and practitioner issues via phone or face to face to support quality goals.
Humana Inc. is committed to putting health first for teammates, customers, and the company. Through Humana insurance services and CenterWell healthcare services, they strive to make it easier for millions to achieve their best health, delivering needed care and service.
Assist members with online registration and navigation for our web portal and mobile app.
Educate members about OTIP’s products and services to ensure members’ needs are being fully met by OTIP.
Provide timely and accurate information in response to incoming telephone inquiries using an automated telephone system, computer applications, training material and other applicable resources.
OTIP Group of Companies (OGC) believes that something special happens when employees feel valued for the work they do, supported as the people they are, and included in the very fabric of the organization. They deliver meaningful benefits support and service.
Own the monitoring, analysis, and interpretation of state and federal legislation, regulations, and administrative rules.
Review, redline, and propose changes to legislation and regulations and evaluate proposals for impact, compliance, and risk.
Engage directly in the legislative process alongside the Government Affairs & Public Policy team.
Proof is shaping the legal and regulatory environment surrounding digital identity, remote online notarization, future of workforce, privacy, AI governance, and fraud prevention technologies. They aim to ensure its platform remains compliant, secure, and trusted.
Responsible for the strategic oversight, execution, and continuous improvement of all provider credentialing, re-credentialing, payer enrollment, contracting coordination, and licensure activities across all AnswersNow business entities.
Ensures that providers and groups are credentialed, contracted, and licensed accurately and on time so that services may be delivered, billed, and reimbursed without delay.
Leads the credentialing team, manages external vendors, partners cross-functionally with RCM, growth, operations, scheduling, and technology teams, and delivers clear, data-driven reporting to executive leadership.
AnswersNow is innovating autism therapy by making it more immediate, accessible, and effective for families. Their remote team allows for a flexible work-from-home environment, providing client support without the need to report on-site.
Oversee the operations of the Imagine Pediatrics Onboarding, Credentialing, Licensing, and Enrollment Department. Develop and train on policies and procedures, workflows, and training documentation for the team. Manage Delegated Credentialing arrangements - implementation and audit – as well as ongoing Delegated partnerships with health plans.
Imagine Pediatrics is a tech enabled, pediatrician led medical group reimagining care for children with special health care needs.
Serve as the go-to clinical expert for clinician questions and escalations. Support patient care, including escalated and DEA-required visits. Partner with the Medical Director on clinical quality, education, and safety.
Midi Health is the leading virtual clinic for women in midlife, transforming the way perimenopause and menopause are treated with expert, evidence-backed care.
Provide guidance to employees and managers on HR-related needs of varying complexity.
Ensure HR policies, benefits, payroll and employee practices remain compliant with multistate and local employment laws.
Facilitate the onboarding process for new hires, including orientations, benefits, training, and organizational culture.
Mediafly's platform brings together sales enablement, content, and performance insights so sellers have the coaching, tools, and intelligence they need to succeed. They are a collaborative, growth-focused team that values expertise, creativity, and human connection.
Assists with medical record documentation requests and leverages medical management system to initiate case and/or authorization to support clinical processes.
Conducts fax and telephonic outreach; and written communications to members and/or providers to communicate status of UM/CM processes.
Actively participates in supporting department compliance and performance through administrative activities such as report monitoring/distribution, and other tasks as assigned by leadership.
Capital Blue Cross promises to go the extra mile for their team and community. Employees consistently vote it one of the “Best Places to Work in PA”.
Authorizes and reviews utilization of mental health and substance abuse services.
Collects and analyzes utilization data and assists with discharge planning and care coordination.
Provides member assistance with mental health and substance abuse issues, and participates in quality improvement projects.
Magellan Health, Inc. is committed to making a difference in the healthcare industry and communities. They value professional growth and development, total health and wellness, rewards and recognition, as well as employee unity, offering a place where you can thrive.
Manage and implement country-level efforts with government counterparts and development bank teams.
Manage the planning and implementation of AIM for Scale’s events, workshops, and stakeholder convenings.
Prepare outreach materials, including digital content and social media updates.
The University of Notre Dame is a mission-driven community where every employee is valued and supported. They are committed to fostering an environment of care that nurtures the whole person and offers an opportunity to grow your career while being a force for good in the world.