Manager- Healthlink, FT, Days Job at North Mississippi Medical Center
Essential Functions
Operations: This leadership position has responsibility for managing the payor credentialing and payor enrollment processes for Health Link. This includes leading the provider credentialing efforts and assuring that results adhere to NCQA standards for the NMHS proprietary provider networks, including the Health Link PPO and the Connected Care Partners Clinically Integrated Network.
Additional responsibilities include the management of delegated credentialing services for several health plans contracted with Health Link and/or NMHS, including the commercial health plans, MS CAN (Managed Medicaid) network agreements, Medicare Advantage plans and Federal Marketplace health insurance plans.
NMHS Finance Vertical Support Services: In addition to the credentialing and delegated responsibilities, the Manager will lead a team of third-party payor enrollment specialists. The Health Link Payor enrollment team actively manages the enrollment of NMHS facilities and employed providers with multiple health insurance carriers/payors, including Medicare, Medicaid (MS and AL), BCBS of MS, BCBS of AL, Tricare, and others. These same enrollment specialists lead the ERA/EFT enrollment with multiple payors which have members accessing NMHS locations .
Leadership: The Manager will serve as an active support liaison for the Health Link Credentials Committee Chairman, the Health Link Credentials Committee members and the Health Link Credentialing Board of Directors.
Direct Staff Supervision: Supervises the Health Link staff including interviewing, hiring, coaching and disciplinary action.
Job Knowledge
Operations: This leadership position has responsibility for managing the payor credentialing and payor enrollment processes for Health Link. This includes leading the provider credentialing efforts and assuring that results adhere to NCQA standards for the NMHS proprietary provider networks, including the Health Link PPO and the Connected Care Partners Clinically Integrated Network.
Additional responsibilities include the management of delegated credentialing services for several health plans contracted with Health Link and/or NMHS, including the commercial health plans, MS CAN (Managed Medicaid) network agreements, Medicare Advantage plans and Federal Marketplace health insurance plans.
NMHS Finance Vertical Support Services: In addition to the credentialing and delegated responsibilities, the Manager will lead a team of third-party payor enrollment specialists. The Health Link Payor enrollment team actively manages the enrollment of NMHS facilities and employed providers with multiple health insurance carriers/payors, including Medicare, Medicaid (MS and AL), BCBS of MS, BCBS of AL, Tricare, and others. These same enrollment specialists lead the ERA/EFT enrollment with multiple payors which have members accessing NMHS locations .
Leadership: The Manager will serve as an active support liaison for the Health Link Credentials Committee Chairman, the Health Link Credentials Committee members and the Health Link Credentialing Board of Directors.
Direct Staff Supervision: Supervises the Health Link staff including interviewing, hiring, coaching and disciplinary action.
Job Knowledge
- Bachelor’s Degree in marketing, business administration, or health care required.
- Previous health care benefit experience, preferably in a leadership position for payor credentialing and payor enrollment processes within a managed care environment, required.
- Previous supervisory experience in a healthcare business environment, preferred.
Job Qualifications
Highest Education Level Required:
Bachelors
Compensation
Location and Work Requirements
Shift:
Day
Weekends:
No
Please Note :
cpscodex.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, cpscodex.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.