Responsible for coordination and facilitation of the Credentialing/Recredentialing Process for Cook Children's Healthcare System which includes communication with insurance organizations, managed care organizations, healthcare delivery systems, Regulatory Organizations and Providers. Handles information from a variety of sources in a highly confidential manner. These sources include Providers, as well as National Databases and Regulatory Organizations.
Qualifications:
High school or equivalent required; some college preferred.
3-5 years' experience working with hospital and/or managed care products and programs.
Includes experience with the credentialing process, audit process, and NCQA and Joint Commission Standards and Guidelines, as well as other external accreditation standards
Require CPCS or CPMSM Certification or ability to be certified within four years of employment.
About Us:
Cook Children's Health Care System offers a unique approach to caring for children because we are one of the country's leading integrated pediatric health care delivery organizations. Patients benefit from the integrated system because it allows Cook Children's to use all of its resources to treat a patient and allows for easy communication between the various companies by physicians with a focus on caring for children and adolescents.
Cook Children's is an EOE/AA, Minority/Female/Disability/Veteran employer.
Cook Children's Health Care System embraces an inspiring Promise—to improve the health of every child in our region through the prevention and treatment of illness, disease and injury. Based in Fort Worth, Texas, we're proud of our long and rich tradition of serving the community.Our not-for-profit organization is comprised of eight companies, including our medical center, physician network, home health company, surgery centers, health plan, health services, and health foundation. With more than 60 primary, specialty and urgent care locations throughout Texas, families can access our top-ranked specialty programs and network of services to meet the unique needs of their child.For more than 100 years we've worked to improve the health of children from across our primary service area of Denton, Hood, Johnson, Parker, Tarrant and Wise counties. We combine the art of caring with leading technology and extraordinary collaboration to provide exceptional care for every child. This has earned Cook Children's a strong, far-reaching reputation with patients traveling from around the country and the globe to receive life-saving pediatric care. Cook Children's is honored to continually receive... recognition for our outstanding efforts and outcomes in pediatric health care.At Cook Children's, we believe that childhood should be simple. But when things get complicated, we also believe that every child has the right to the very best care possible.