This position’s main function is to credential and re-credential behavioral health providers in Beacon’s network spanning multiple states and regions. The position will perform specified assignments relating to ensuring that processes and protocols are in place to ensure all credentialing file accuracy according to contractual and NCQA standards
Credentials and recredentials behavioral health providers using Beacon’s proprietary FlexCare system;
Organizes and maintains credentialing files;
Works with Network Operations and other Beacon staff to ensure follow up with providers when applications are incomplete
Performs Primary Source Verification for individual credentialing & confirmation of facility accreditation and licensure
Maintains credentialing management documents
Tracking of all credentialed providers for the purpose of re credentialing
Accurately enter information into Beacon’s system of record
Monitor and participate in site visit and provider scores
Knowledge of NCQA credentialing and re credentialing standards
Assists with the revisions and/or development of policies and procedures
Prepares files for at least a quarterly Credentialing Committee;
Assists with the coordination of Credentialing Committee
Participates in evening Credentialing Committee meeting on a monthly basis
Record minutes from Credentialing Committee
Supports special projects as needed.
Other Duties as assigned.
Bachelor’s degree preferred; HS and applicable experience considerd. 2-3 years experience in behavioral health environment preferred. Previous credentialing experience required. Word, Excel and Powerpoint experience required Strong organizational skills and attention to detail required.
Beacon Health Strategies, LLC - 19 months ago
COMPREHENSIVE CARE SINCE 1996
In close partnership with health plans, we help bring together the fragmented pieces of healthcare to achieve...