Job Description

JOB SUMMARY

The primary accountability for this position is to facilitate the verification of hospital privileges by working with hospital medical staff, and when appropriate, facilitating an internal review process to waive privileges when there is an identified business need.

KEY RESPONSIBILITIES

• Facilitate the verification of provider hospital privileges from a primary source for all lines of business. Develop relationships with hospital medical staff departments.
• Facilitate targeted data accuracy/audit processes to ensure regulatory compliance, i.e. CMS required Directory Accuracy Quarterly Audit.
• Perform other job-related duties as assigned.

QUALIFICATIONS

• Excellent presentation skills and the ability to speak and work effectively with personnel at all levels inside and outside the organization.
• Self-motivated with the ability to handle multiple tasks and work with minimal supervision.
• Ability to work on multiple projects concurrently.
• Possess strong oral and written communication skills.
• Successful completion of Health Care Sanctions background check.

EDUCATION/EXPERIENCE:

• Bachelor’s degree in business, marketing or related field OR Associates degree in business, marketing or related field and 3 years related work experience.
• Experience in insurance, healthcare, benefits or related field.

CommunityCare is an equal opportunity at will employer and does not discriminate against any employee or applicant for employment because of age, race, religion, color, disability, sex, sexual orientation or national origin