TEMP TO PERM ROLE

About Diana Health

Diana Health is a network of modern women’s health practices working in partnership with hospitals to reimagine the maternity and women’s healthcare experience. We are restructuring the traditional approach to care to create an experience that is good for patients and good for providers. We do that by combining a tech-enabled, wellness-focused care program that women love with a clinical system that helps us drive continuous quality improvement and ensure work-life balance for our care team. We work with clients across all life stages to empower and support them to live happier, healthier, more fulfilling lives.

With strong collaborative care teams; passionate administrators and a significant investment in operational support, Diana Health employees are well-supported to bring their very best to the work they love. Come join us!

Role Description

Our Payer Credentialing Specialist will be responsible for payer enrollment, revalidations, provider data management and other miscellaneous tasks required by the payers. This individual is familiar with various payer platforms, including but limited to CAQH, Availity, PECOS, TennCare, AHCA, TMHP.

In this role you will:

• Submit payer credentialing applications for Commercial, Medicare and Medicaid payers in Tennessee, Florida and Texas. Managing their status and communicating expected timelines and effective dates to the Practice Manager, Regional Clinical Directors and Billing team.
• Complete the processes to re-credential existing providers as need
• Manage providers’ CAQH profiles, ensuring they are attested every 120 days and all required documents are up to date in their profiles
• Maintain state specific master provider databases; managing expiration dates for provider licenses, DEAs and board certifications and communicating upcoming expiration dates to Practice Managers as needed
• Review, and update if necessary, health plan directories for current and accurate provider information
• Other duties as assigned

Benefits (Temp)

• Competitive compensation

Benefits (Full Time)

• Competitive compensation
• Medical, dental & vision plans, with an HSA/FSA option
• 401(k) with employer match
• Paid time off
• Paid parental leave

Diana Health Culture

• Having a growth mindset and striving for continuous learning and improvement
• Positive, can do / how can I help attitude
• Empathy for our team and our clients
• Taking ownership and driving to results
• Being scrappy and resourceful