Managed Care Credentialing Specialist - (Museum District)

At Houston Methodist, the Managed Care Credentialing Specialist position is responsible for the timely and accurate completion and submission of managed care credentialing documents for new physicians and advanced practice practitioners (APPs). Duties for this position include credentialing and enrollment in governmental and commercial managed care plans and medicare and medicaid. The Managed Care Credentialing Specialist position has consistent interaction with the new providers, Administrators, health plans (commercial and governmental), and the department.

Requirements:

Qualifications:

LICENSES AND CERTIFICATIONS - REQUIRED

• N/A

LICENSES AND CERTIFICATIONS - PREFERRED

• CPMSM - Certified Professional Medical Services Management (NAMSS) OR
• CPCS - Certified Provider Credentialing Specialist (NAMSS)

KNOWLEDGE, SKILLS, AND ABILITIES

• Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations

• Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security

• Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles

• Must be self-motivated with excellent organizational skills to ensure ability to track and manage large volumes of documents

• Ability to manage multiple priorities and projects

• Detail oriented with desire for producing work with 100% accuracy

• Intermediate level of computer competency - Microsoft Office Suite

SUPPLEMENTAL REQUIREMENTS

WORK ATTIRE

• Uniform No
• Scrubs No
• Business professional Yes
• Other (department approved) No

ON-CALL*
*Note that employees may be required to be on-call during emergencies (ie. DIsaster, Severe Weather Events, etc) regardless of selection below.

• On Call* No

TRAVEL**
**Travel specifications may vary by department**

• May require travel within the Houston Metropolitan area No
• May require travel outside Houston Metropolitan area No

Company Profile:

Houston Methodist Specialty Physician Group is an integral part of Houston Methodist’s overall strategy to become one of the nation’s leading academic medical centers. Established as a nonprofit corporation certified by the Texas State Board of Medical Examiners, the Specialty Physician Group enables physicians to maintain autonomy with respect to clinical practice while growing their practice within an academic environment.

Houston Methodist is an Equal Opportunity Employer.

Equal employment opportunity is a sound and just concept to which Houston Methodist is firmly bound. Houston Methodist will not engage in discrimination against or harassment of any person employed or seeking employment with Houston Methodist on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, status as a protected veteran or other characteristics protected by law. VEVRAA Federal Contractor – priority referral Protected Veterans requested.