*Position Description: Credentialing Specialist  *

　　Under the direction of the URAC IRO Manager and Human Resources Manager, the Credentialing Specialist position is involved in all aspects of  credentialing of healthcare professionals.  Upon receipt of signed agreement, the Credentialing Specialist initiates the appropriate onboarding tasks and follows along to ensure completion along with appropriate document maintenance and storage. This individual monitors credentialing files for professional staff to ensure that files are current and accurate.

　　  Responsibilities: 

　　Understand and represent PRI's mission, vision, and values to all internal and external customersInteract with government and private sector clients, partners, and PRI™ staff in a professional and accountable manner, and as a representative of PRI managementInteract with project team members in order to successfully fulfill contract obligations with the highest quality and in a timely manner meeting PRITM's ISO requirementsInstills integrity throughout the organization via active participation in ISO requirements including but not limited to timely submission of Corrective Action Plans for all matters in which either PRITM standards and/or corporate contract standards have not been met. Communicates outcomes to team members to ensure a positive, open, environment which mitigates risk and achieves a culture of Continuous Quality ImprovementEngage clients in appropriate communication that manages client expectations and builds a collaborative relationship with the clientProactively manages and coordinates activities to ensure timeliness of deliverables to exceed contractual obligationsContributes to business development efforts for new sales and marketing to promote the business through professional communications, sound decisions and by exceeding all contract timeframes and deliverable requirements,Serves as a primary relationship conduit between health professionals and PRI and functions as a liaison to health professionals for the organizationDocuments and communicates outcomes within corporate files and disseminates as requiredPresents Consulting Agreements and/or Employment Agreements to panel member candidates as outcomes and approval by PRI Medical Directors and/or PRI Senior Leadership Create and maintain licensing, and credential records within corporate and government systems, as required.Obtain and archive letters of good standing on credentialed individualsObtain and verify active licenses on credentialed individualsObtain current CV/resumes from credentialed individualsVerify and obtain proof of degrees earned by credentialed individualsVerify valid board membership/certification status of credentialed individualsVerify current patient care history of credentialed individualsCompletes verification that credentialed individuals against the Excluded Parties List (EPLS) and the HHS-OIG Fraud Prevention and Detection Exclusion List (LEIE)Obtain history of credentialed individual from the National Practitioner Data Bank(NPDB)Completes verification of /health professionals on National Sex Offender Data BaseReport any and all adverse actions to the URAC IRO Manager/HR Manager and the Chief Compliance Officer for adjudication.Assists health professionals and PRI employees to complete documentation and submission of such documentation within government systems to obtain PIV cardsMonitor license and credential expiration dates and advise panel members and staff members of required "renew by" datesEnsures credentialing and recredentialing is current and timely; reports any and all deficiencies prior to "renew by" dates.Ensure panel members and staff members are maintaining compliance with regulatory and accrediting institutionsDevelop, maintain and disseminate status reporting weekly r more frequently if requested or directed.Participate in interdisciplinary collaboration with PRI staff, recognized teaming partners, and/or subcontractorsPerform other duties as requestedRequirements:

　　Bachelor's degree in health care administration or business administration; additional 5 years of direct experience in credentialingMinimum of 2-5 years direct experience in credentialing required Proven skill and experience in excellent oral and written communication spanning executives to the general publicReliable and trustworthy; Integrity is requiredExcellent organizational skills and ability to pay attention to detailAbility to contribute to and work effectively within a team environmentAbility to interface with management and contract staff personnelProficient user of Microsoft office suite such as Outlook, Access, Excel and WordAbility to be discrete and maintain confidentialityMust have no adverse actions pending or taken against him/her by any State or Federal licensing board or program, if appropriateMust have no conflict of interest (COI) as defined in 1154(b)(1) of the Social Security Act (SSA)Ability to obtain and maintain U.S. Government Security Clearance* *Preference will be given to individuals who reside in, or are willing to relocate to, a recognized HUBZone area.  (Go to www.sba.gov/hubzone for more information).

　　FLSA Status: Exempt

　　The PRI Corporate Compensation Plan is applicable to this position.

　　PRI is an equal employment opportunity employer. All qualified applicants including Disability/Vets or other qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law

　　Qualified candidates may apply by clicking, "Apply Now". Next, submit your resume. You may complete a cover letter on the following screen. *You must contact the employer via one of the methods listed on the screen after clicking "Apply for this job". * Please be sure to identify PA CareerLink as your referral source.