Primary City/State:

Arizona, Arizona

Department Name:

Credentialing

Work Shift:

Day

Job Category:

Administrative Services

Great careers are built at Banner. We understand that talented professionals appreciate having options. We are proud to offer our team members many career and lifestyle choices including remote & hybrid work options. Apply today.

Banner Plans & Networks (BPN) is an integrated network for Medicare and private health plans. Known nationally as an innovative leader, BPN insurance plans and physicians work collaboratively to keep members in optimal health while reducing costs. Supporting our members and vast network of providers is a team of professionals known for innovation, collaboration, and teamwork. If you would like to contribute to this leading-edge work, we invite you to bring your experience and skills to BPN.

As a Credentialing Network Assistant at Banner Plans & Networks, you will play a critical role. You will manage the external site audit coordination. You will collaborate with external and internal partners and groups to ensure appropriate documentation and timely completion of the audits. You will also update systems, track applications, manage deadlines, and facilitate credentialing committee meetings.

This entirely remote role will work Monday-Friday adhering to Arizona Time Zone business hours. If this role sounds like the one for you, apply today.

Banner Health Network (BHN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. Through BHN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs.

POSITION SUMMARY
This position provides administrative services and assistance requiring occasional discretion and judgment. Coordinates a unique set of processes and/or services for an assigned area such as credentialing. Responsible for coordination of multiple provider networks to include delegation agreements, manages committee structures, leads credential committee meetings.

CORE FUNCTIONS
1. Lead role in preparing documentation, create agendas, meeting invitations and facilitating the necessary materials for credentialing committee review. Facilitates the credentialing committee meeting.

2. Reviews and/or audits documents, forms or stipends for appropriateness/accuracy.

3. Corresponds with customers, team members, committee members, BHN leadership and senior leadership, legal, and medical leadership using defined formats and procedures, via verbal, electronic and written communications.

4. Maintains confidential records and required documentation for assigned area. Ensures appropriate documentation is timely and accurately entered into departmental application(s).

5. As assigned, prepares, collates, and distributes various reports in a timely and accurate manner. May complete or handle recurring department projects or one-time projects, as directed by supervisor.

6. Conducts internal team audits and reports findings to supervisor on a monthly basis.

7. Oversees the credentialing appeals process.

8. Works independently under general supervision. Represents the company as a primary point of contact to outside entities such as delegated health plans, community providers and offices, etc.

MINIMUM QUALIFICATIONS
Must possess a strong knowledge of business and/or healthcare as normally obtained through the completion of an associate’s degree and 3-5 years of credentialing and/or process management and operations experience in a related area.

Must have the ability to follow oral and written directions as they relate to the functions listed above. Must have excellent oral, written and interpersonal communication skills to effectively interact with departmental personnel, assist customers with inquiries, schedule meetings and appointments, as well as provide assistance with incoming telephone calls and walk-ins. Requires the ability to work effectively with common office software, including spreadsheets and word processing. Must have the ability to organize, prioritize and multi-task workload in a fast-paced environment and maintain a professional manner.

PREFERRED QUALIFICATIONS
Additional related education and/or experience preferred.

EEO Statement:

EEO/Female/Minority/Disability/Veterans

Our organization supports a drug-free work environment.

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