Student Veterans of America Jobs

Req# 27454 Aultman Health Foundation, CANTON, OH AULTCARE ADMINISTRATION Aultman Health Foundation Full Time, Day Shift, 8-5 PRIMARY PURPOSE The purpose of your position is to assist the department supervisor and with day to day operations within Networks, Credentialing and Contracting Departments. It is expected of the employee to develop, implement and maintain an accurate provider data base; analyze provider data, facilitate the preparation and follow-up of the monthly activities of the Membership Services Committee and PEER committee; track and report provider based information using Department databases; and serve as a communication link with Provider offices and other AultCare Departments regarding the status of providers. Other primary responsibilities include help with various compliance and accreditation standards that are constantly evolving throughout the department. Each person will be assigned a focus area of either membership or credentialing within the department. RESPONSIBILITES/DUTIES/EXPECTATIONS: Maintain a thorough knowledge and meet important industry standards set forth by organizations such as NCQA, CMS, ODI, QHP, CAQH, etc. Helps in coordinating updating of policies and procedures as necessary to comply with these standards. Consistently plans, organizes and completes tasks independently and thoroughly in the allotted time frames ensuring the departments' day to day work is completed (networks, credentialing and contracting). Subject to frequent interruptions, ability to be flexible when priorities change. Supports the day-to-day operations (networks, credentialing and contracting) by making appropriate recommendations to supervisor for changes within the Department, including process improvement and problem solving. Responsible for tracking and reporting own stats. Problem solve, handles difficult and sensitive issues with tact; exercises judgment where necessary and consults supervisor on major problems and issues. Team player, works across departmental lines while maintaining positive interactions with both internal and external customers. Prepare and post follow-up of the monthly activities of the Membership Services Committee and PEER committee (including but not limited to analyses, minutes, summaries, letters, etc.). Responsible for running queries and reporting. Analyze information to make meaningful recommendations to supervisor. Communicates regularly and appropriately with supervisor and co-workers and reports and accurately documents pertinent information. Maintains positive attitude and is cooperative in all duties. Communicates with providers, co-workers, and other health care professionals in a professional and respectful manner. Practices ethical conduct including, honesty, integrity, confidentiality and compliance with policies and procedures. Meets acceptable attendance and punctuality expectations (excluding FMLA). Seek supervisory guidance/approval as appropriate. Assist with orientation of new personnel into the department. Participate in quality review process of department. Ability to adapt to new software changes; maintain accuracy of current software, as well as, make suggestions/recommendations for continued streamlining of database and information. Promotes and demonstrates professional standards to enhance the development of the department including: portrays professional image, follows dress code, strong organization skills, strong computer skills, strong communication skills, actively seeks and pursues opportunities to make a contribution and demonstrates desire for learning. The above statements reflect the general duties considered necessary to describe the principle functions of the job as identified and are not a detailed description of all the work requirements that may be inherent in this position. All qualified applicants will receive consideration f