North Carolina Community Health Center Association

POSITION: Credentialing Specialist REPORTS TO: Network Development Manager, NCCHCA STATUS: Fulltime, Exempt

CMHN Overview

The North Carolina Community Health Center Association (NCCHCA) is the HRSA-funded state primary care association (PCA) serving federally qualified health centers. NCCHCA is the sponsor and managing partner of the Carolina Medical Home Network (CMHN) sub- corporations. Carolina Medical Home Network (CMHN) serves as the clinical and operational performance improvement organization of NCCHCA and member health centers. CMHN is a 33 member HRSA-funded Health Center Controlled Network (HCCN) currently in the second three-year funding cycle. Carolina Medical Home Network – Accountable Care Organization (CMHN-ACO) is a partnership of 8 NC health centers that have entered into the Medicare Managed Care Shared Savings Program, currently in Program Year 3. Carolina Medical Home Network – Independent Practice Association (CMHN-IPA) is a network of 31 NC health centers striving towards clinical integration with the goal of leveraging size, scope and coordinated performance improvement in third-party payer negotiations. CMHN-ACO serves as the pilot for identification of population health strategies to scale up to the larger CMHN-IPA network.

Position Overview Credentialing Specialist (CS) is a grant-funded position which coordinates credentialing and provider data management services associated with CMHN initiatives. The CS ensures timely, accurate, and effective communication between CMHN staff and health centers (both current and new) as related to these services.

Responsibilities:  Maintains functional familiarity with all components of NCCHCA’s provider data management software system.  Primarily responsible for all data entry and maintenance related to NCCHCA’s provider data management software system.  Assists NCCHCA staff with the establishment and implementation of policies, procedures, work flows and best practices associated with credentialing services and enrollment activities.  Corresponds with health center staff for timely data collection to meet credentialing and enrollment related deadlines.  Participates in NCCCHCA strategic discussions on the implementation and expansion of credentialing services.  Coordinates the collection and implementation of health center feedback on the development of NCCHCA’s credentialing services.  Maintains the collection and submission of all provider-related data, as relevant to NCCHCA’s credentialing software, and as requested by NCCHCA funders, member health centers, and other third parties.  Assists the Network Development Manager in the facilitating the FQHC Credentialing & Enrollment Advisory Committee.  Assists with special projects and support within other areas of CMHN and NCCHCA as instructed by the Network Development Manager.

Minimum Qualifications 1. Bachelor’s Degree plus 1 year of relevant experience required, or Associate’s Degree plus 4 years non-profit or community health center administrative experience may substitute for BA degree requirement. 2. One (1) year experience providing credentialing services and/or support required. NAMMSS CPSC Certified and/or 2 years of experience preferred. 3. Competence in Microsoft Office applications, particularly Word and Excel. 4. Familiarity with commercial and other third party contracting preferred. 5. Experience with Vistar Technology’s eVIPS credentialing software suite preferred. 6. Excellent written/verbal communication and problem solving skills. 7. Experience and/or familiarity with Community Health Centers and or safety-net primary care providers preferred. 8. Willing to travel to and work at off-site events and conferences, as requested.