Delegated Credentialing Specialist

About The Role

We’re looking for an experienced Delegated Credentialing Specialist who is passionate about improving the landscape for mental healthcare. In this role you’ll play a key role in getting our providers in-network with some of the country’s largest health plans. Responsibilities include:

• Review our flagged provider files to make sure we have all of the necessary information before bringing an application in front of our Credentialing Committee

• Participate in facilitating the Credentialing Committee meetings

• Lead the charge on reviewing audit files and pull together the necessary materials

• Review and approve collaborative agreements ensuring compliance with state-level regulations and Grow policies

• Collaborate with our operations teams to identify and facilitate process improvements

• Remain up-to-date on NCQA and industry standards. Propose necessary changes to current policies and procedures/operations

• Review and submit documentation and reports per payor requirements

• Manage special projects as needed

You’d be a great fit if...

• You’re a credentialing expert. You’ve prepped for delegated committees before and you meet the following requirements:

  • Certified Provider Credentialing Specialist (CPCS) with at least two years of experience in Provider Credentialing OR at least three years of experience in Provider Credentialing

  • Strong familiarity with credentialing processes terminology and primary source verification resources; these include: CAQH NPDB PECOS State Licensing Accreditation and Certification agencies

• You have excellent communication skills.  You have the ability to be persuasive and credible with a wide variety of audiences both internal and external.

• You’re tech savvy. You’ve efficiently learned new software in the past and you’re willing to learn HubSpot Verifiable Slack and Excel if you don’t know how to use them already.

• You can maintain confidentiality and discretion in all communications on behalf of credentialing applicants.

• You’re detail oriented. You understand the importance of strong attention to detail when scrubbing or reviewing files.

The salary range for this position is $73102 - $90000 USD.

If you don’t meet every single requirement but are still interested in the job please apply. Nobody checks every box and Grow believes the perfect candidate is more than just a resume.

Note: Please upload your resume in PDF format