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Credentialing Specialist

Overview

The Visiting Nurse Service of New York (VNSNY) is the nation's largest not-for-profit home- and community-based health care organization, serving the five boroughs of New York City, and Nassau, Suffolk, and Westchester Counties. For 125 years, VNSNY has been committed to meeting the health care needs of New Yorkers with compassionate, high-quality home health care. We offer a wide range of services, programs, and health plans to meet the diverse needs of our patients, members, and clients from before birth to the end of life.

Each day, more than 13,000 VNSNY employees- including nurses, rehabilitation therapists, social workers, other allied professionals, and paraprofessionals- deliver compassionate care, unparalleled medical expertise, and 24/7 solutions and resources to more than 48,000 patients and members, helping them to live the best lives possible in their homes and communities.

Responsibilities

Performs activities related to credentialing and re-credentialing of network providers, while ensuring adherence to the Health Plan, regulatory, industry and delegation standards. Conducts credentialing audits; oversees maintenance of documentation, provider files and related databases. Works under general supervision.

Education: Associate's degree in business, healthcare administration or a related field, or the equivalent required. Bachelor's degree in business, healthcare administration or a related field, or the equivalent preferred.

Experience: Minimum of two years managed care or hospital experience, preferably in the area of credentialing or provider relations required. Proven track record of credentialing and re-credentialing processes with an emphasis on compliance to NCQA, Medicare and Medicaid regulatory standards and requirements. Excellent organizational and PC skills required. Strong written and verbal communication skills, and ability to work independently in a team environment required.

CA2019

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