Experience Inc. Jobs

Facility: Health Plan

City San Diego

Department

Job Status

Regular

Shift

Day

FTE

1

Shift Start Time

Shift End Time

H.S. Diploma or Equivalent; Certified Provider Credentialing Specialist (CPCS) - National Association Medical Staff Services

Hours :

Shift Start Time:

8 AM

Shift End Time:

5 PM

AWS Hours Requirement:

8/40 - 8 Hour Shift

Additional Shift Information:

Weekend Requirements:

Not Specified

On-Call Required:

No

Hourly Pay Range (Minimum - Midpoint - Maximum):

$27.280 - $34.100 - $40.920

The stated pay scale reflects the range that Sharp reasonably expects to pay for this position.  The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant’s years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.

What You Will Do

Under general supervision, the Network Administrative Assistant is responsible for network administrative services functions including administrative support for credentialing, network management and application optimization.

Required Qualifications

• H.S. Diploma or Equivalent

• 2 Years office experience, preferably in a health care setting.

Preferred Qualifications

• Certified Provider Credentialing Specialist (CPCS) - National Association Medical Staff Services -PREFERRED

Essential Functions

• Accurately prepares correspondence Composes correspondence, memos, presentations, flyers, spreadsheets, and other documents as requested. Drafts complex documents from abstract ideas and general information.Researches and gathers data from various sources and generates special projects/reports/summaries. Report generation may involve analyzing statistics and preparing spreadsheets, databases or other documents.Proficient in the use of computer applications to complete documents/work assignmentsReviews and edits materials as requested.

• Communication and record maintenance Prioritizes mail (including electronic mail), checks deadlines and independently initiates responses/action items or refers appropriately.Develops and maintains databases and uses computer applications as appropriate.Initiates establishment and maintenance of record keeping systems to ensure efficient retrieval of documents.Information and records are kept confidential per guidelines.

• Customer service and teamworkUses scripts as appropriate including answering phones, transferring calls and service recoveryResponds to all inquiries with a timeliness that promotes customer satisfactionCommunicates effectively with all levels of staff and uses chain of command.Communicates direct supervisor(s) instructions or desires to various departments or individuals.Performs other duties, as assigned.

• Credentialing administrative dutiesConducts quarterly provider roster outreach to ensure provider data is up-to-date, per regulatory guidelines.Supports maintenance of provider adds, changes and terminations in the credentialing database.Ability to maintain peer review information confidentiality consistent with California Evidence Code 1157 for credentialing and peer review activities.Prepares Peer Review Committee information summaries for presentation at quarterly Peer Review Committee meetings.Prepares credentialing summaries for all practitioners meeting the Sharp Health Plan threshold criteria for "clean file" and “unclean file” review for presentation at quarterly Peer Review Committee meetings.Performs other duties, as assigned.

• Network and application management administrative dutiesUpdates dashboards and reports, as directed.Edits/updates reports and presentations, as directed.Schedules meetings and related resources and confirms participants.Prepares agenda and attachments, attends meetings, and takes minutes for meetings, as directed.Performs other duties, as assigned.

Knowledge, Skills, and Abilities

• Computer and word processing, and in other office equipment experience.

• Ability to record minutes and perform other related office procedures.

• Able to relate to people in an effective and cordial manner and work in a demanding environment.

• Good organizational ability and ability to function with minimal supervision.

• Position requires a high degree of confidentiality.

Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class