Centerstone is among the nation’s leading nonprofit behavioral health systems with thousands of employees dedicated to delivering care that changes people’s lives. A dynamic, well-established organization, we offer rewarding opportunities to serve all ages in a variety of settings. Come talk to us about joining the Centerstone team!

JOB DESCRIPTION:

Schedule

This is a part time role, up to 24 hours a week. This will be a remote role, but employee must live in Indiana.

SUMMARY OF POSITION

Complying with all credentialing standards of NCQA for all direct care licensed/non-licensed providers as required by the state, managed care companies, and/or third party payers.

ESSENTIAL DUTIES & RESPONSIBILITIES

1) Prepares and submits accurate credentialing/re-credentialing applications for appropriate licensed providers, including maintaining and updating the credentialing files in a timely fashion based on NCQA standards

2) Maintains a working knowledge of payer requirements for credentialing and continues to be apprised of changes as it relates to licensure

3) Prepares credentialing documents and leads credentialing committee for all delegated credentialing contracts

4) Prepares verification communication to appropriate staff when approval for a paneled provider is obtained including maintaining accurate listing of facility providers and payer rosters as new licensed providers are employed and/or terminated

5) Maintains CAQH and assists with NPI certifications for staff which includes updating via websites and submitting appropriate documents in a timely manner

 6) works closely with authorization staff and other organization staff as it relates to credentialing functions

 7) Processes malpractice applications and updates for covered providers;

8) Processes timely credentialing for all new facilities and locations;

9) Prepare credentialing, re-credentialing and subcontracted files at least one business day prior to credentialing meeting

10) Prepare credentialing minutes and distribute CRC approval/denial letters within 5 days of CRC meeting

11) Process information on credentialed staff following each CRC meeting

12) Complete Medicaid credentialing process for applicable staff

13) Complete TennCare credentialing process for all credentialed staff and subcontracted employees

14) Distribute information quarterly to coordinate recredentialing process

15) Manage audits for delegated credentialing process

16) Distribute monthly roster for delegated credentialing policies

17) Prepare quarterly credentialing reports

KNOWLEDGE, SKILLS & ABILITIES

• Effectively communicate via written, verbal, in person and virtual methods.

QUALIFICATIONS

         

Education Level              

High school diploma or GED required. 

Years of Experience       

Three to five years administrative experience preferred.   

Certification/Licensure 

N/A

PHYSICAL REQUIREMENTS

Standing – 20%

Sitting – 80%

Squatting – Occasional

Kneeling – Occasional

Bending – Occasional

Driving – Occasional

Lifting – Occasional

DISCLAIMER

The duties and responsibilities described in this document are not a comprehensive list and additional tasks may be assigned to the employee from time to time, or the scope of the job may change as necessitated by business demands.

Time Type:

Part time

Pay Range:

$18.20--$25.50

Delivering care that changes people's lives starts with our employees. Below are just some of the great benefits Centerstone employees enjoy:

• Medical, dental, and vision health coverage
• Flexible Spending and Health Savings Accounts
• 403b retirement plan with company match
• Paid time off and ten paid holidays
• AD&D Insurance, Life Insurance, and Long Term Disability (company paid)
• Diversity, Equity, and Inclusion employee resource groups
• Continuing education opportunities
• Employee Assistance Program

Centerstone is an equal opportunity employer. Employment at Centerstone is based solely on a person's merit and qualifications directly related to professional competence. Centerstone does not discriminate against any employee or applicant because of race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), or any other basis protected by law.

At Centerstone, we use our values as a guide for what we do. Respect, Expertise, Integrity and Empowerment are at the heart of every interaction at Centerstone, and particularly rooted in our beliefs toward diversity and inclusion.

Our approach to diversity is simple—it’s about embracing everyone. Together, we continue to develop an inclusive culture that encourages, supports and celebrates the diverse voices and experiences of our employees. It powers our innovation and connects us closer to each other, to our clients and the communities we serve. We strive to create a workplace that reflects the growing world around us, and where everyone feels empowered, safe and welcomed.

Centerstone is also committed to a strong culture of quality and safety, celebrating role-models who champion best practices for quality, clinical risk, and patient safety.