Mount Sinai Careers

Delegated Specialist-Medical Staff Services

New York, New York
Professional / Managerial / Administrative


Job Description

 

Strength Through Diversity

Ground breaking science. Advancing medicine. Healing made personal. 

 Medical Staff Services-2296096

 

Job Title:  Delegated Specialist

 
 

Roles & Responsibilities:

The Medical Staff Services Health Care Specialist is responsible for coordinating the Icahn School of Medicine Faculty Practice Associates credentialing, re-credentialing and enrollment process in accordance with the health plan delegated credentialing agreements and the FPA policies & procedures, industry best-practices, and regulatory requirements. 

  • Coordinates and administers all aspects of provider enrollment, including:
    1. FPA- Faculty Practice Associates-Ongoing Auditing & Monitoring of credentials files; Ensures compliance with the accrediting agencies (e.g., NCQA, JCAHO, NYS and Federal)
    2. Working with health plans - Enrollment, data exchange. Monitors timelines of plans response.
    3. Submission of rosters; reconciliation of provider enrollment status
    4. Accountability for accuracy and integrity of the credentialing database
    5. Collection of data from department and physicians;
    6. Gathering and reviewing enrollment requests, applications and contracts for completeness and accuracy
    7. Interaction with plan representatives regarding audits; problems and claims resolution; identify fee schedule issues; and addressing potential corrective action plans and monitoring for a successful resolution
    8. Creating and maintaining accurate systems records. Track all appointments, reappointments, change-in-status, demographic updates, and terminations from plans.
    9. Performing independent verifications as required, including; education, training, experience, certifications and boards
    10. Assisting leadership with setting up audits and preparation of monthly reports
    11. Assisting in the management of junior staff on a day-to-day basis
 
  • Ensuring that all providers are accurately enrolled in health plans Prepares status reports of work performed and next steps.
  • Facilitates communication between department personnel, health plans and MSS operations. Participates in team-based problem solving activities and process improvements.
 
Requirements:
 

Minimum Education

  • Bachelor’s degree or equivalent experience

Minimum Related Experience

  • Minimum of five (5) years related progressively responsible experience in health care administration with general knowledge of Medical Staff Office functions.
  • Preferred experience in health plan Credentialing/Provider Relations and/or auditing setting, or Hospital Health Care Enrollment
  • Ability to communicate effectively with all levels of medical and administrative staff
  

Strength Through Diversity

 

The Mount Sinai Health System believes that diversity is a driver for excellence. We share a common devotion to delivering exceptional patient care. Yet we’re as diverse as the city we call home- culturally, ethically, in outlook and lifestyle. When you join us, you become a part of Mount Sinai’s unrivaled record of achievement, education and advancement as we revolutionize medicine together.

 

We work hard to acquire and retain the best people, and to create a welcoming, nurturing work environment where you can develop professionally. We share the belief that all employees, regardless of job title or expertise, can make an impact on quality patient care. 

 

Explore more about this opportunity and how you can help us write a new chapter in our story! 

 

Who We Are

 

Over 38,000 employees strong, the mission of the Mount Sinai Health System is to provide compassionate patient care with seamless coordination and to advance medicine through unrivaled education, research, and outreach in the many diverse communities we serve.

 

Formed in September 2013, The Mount Sinai Health System combines the excellence of the Icahn School of Medicine at Mount Sinai with seven premier hospital campuses, including Mount Sinai Beth Israel, Mount Sinai Beth Israel Brooklyn, The Mount Sinai Hospital, Mount Sinai Queens, Mount Sinai West (formerly Mount Sinai Roosevelt), Mount Sinai St. Luke’s, and New York Eye and Ear Infirmary of Mount Sinai.

 

The Mount Sinai Health System is an equal opportunity employer. We promote recognition and respect for individual and cultural differences, and we work to make our employees feel valued and appreciated, whatever their race, gender, background, or sexual orientation. 

 

EOE Minorities/Women/Disabled/Veterans