Quality Improvement Specialist

 

Apply here: https://bertnash.e3applicants.com/careers/

Pay is based on experience - $15.84 - $27.71 Full Time - 40 hours per week, benefits eligible.

Caring. Hope. Giving back. Do these words resonate with you? If so, please keep reading.

Our goal at the Bert Nash Center is to build a healthier community by responding to needs and working to restore lives. We accomplish this by believing in our team. Each person that works for the Bert Nash Center contributes directly to the success of our clients, organization, and community.

Our values of compassion, integrity, equity and hope reflect in everything we do. 

Responsibilities:  

The primary responsibility of the Quality Improvement Specialist is to oversee the credentialing process and to support the preparation process in seeking national accreditation. The Quality Improvement Specialist manages credentialing, assists with training coordination, supports the accreditation efforts, develops data analytics, and assists IT as needed.

Some specific duties include:

  • Collect all required information and documents from new and current providers to keep insurance rosters updated
  • Submit applications and roster updates for new providers to all contracted insurance companies we are contracted with as quickly after the provider accepts a job as possible
  • Maintain thorough and accurate documentation of all credentialing-related communications and actions for each provider
  • Respond to frequent provider information requests from insurance companies, staff, and supervisors in a timely manner
  • Respond to roster-related issues from the billing department if claims are denied
  • Maintain and create provider CAQH accounts, including regular attestations
  • Track providers' licenses through the BSRB website ensuring all remain active

Qualifications

  • High School Diploma or GED equivalent;
  • Prior credentialing, data analytics, quality improvement, or related experience in a position of similar scope;
  • Knowledge of risk, regulatory, compliance and HIPAA requirements beneficial;