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OCA Ventures

Credentialing Coordinator



Remote · Connecticut, USA
Posted on Wednesday, September 13, 2023
We are looking for an experienced, detail-oriented, organized, and driven . The ideal candidate will have significant expertise and ability to accurately and timely coordinate, facilitate, the cross licensing of clinicians and assist with the initial appointments and the reappointments of our clinicians. Experience in the substance use treatment setting is preferred.
What You’ll Do:

Specific hands-on and mission-critical initiatives may include:
  • Organize and facilitate the cross licensing of clinicians in states requested and communicates with operations regarding updates and the issuance of licenses. This includes additional states (CSR), and federal licenses (DEA).
  • Notifies the Enrollment and Operations team of license issuance for timely enrollment into new state payer plans and for scheduling of patient care.
  • Assists in maintaining and updating all clinician licenses for renewals and compliance
  • Assists in the management of the medical staff support function for PursueCare as outlined in the Credentials Plan.
  • Coordinates and processes the credentialing and privileging applications in accordance to the Credentials Plan, NCQA and Joint Commission for compliance. Performs review and analysis, identification and follow up of "red flag" items; prepares files for review and recommendation by the medical staff.
  • Coordinates credentialing end-of-committee process to ensure notification of clinicians, departments; database updates; breakdown, completion and scanning of files as appropriate.
  • May assist with processing all new appointments and reappointments off to our Delegated Plans via plan rosters etc and assist with the yearly delegated plan audits.
  • Generates queries and reports from credentialing and privileging database.
  • Performs miscellaneous job-related duties as assigned.
  • Proactively address/escalate any concerns/issues to management.
  • Work collaboratively throughout the organization in an advisory capacity to meet credentialing and privileging goals and objectives. Suggest and implement continuous quality and process improvement solutions and provide collaborative high-quality service.
We’re Looking For:
  • High School diploma or GED required. Associates Degree is preferred.
  • Minimum of 5 years clinician credentialing experience is required.
  • CPCS certification is preferred.
  • Experience in substance use treatment and/or behavioral health setting is preferred.
  • Excellent and thoughtful verbal and written communication skills
  • Excellent organizational skills
  • Drive to take ownership in order to meet professional obligations
  • Ability to juggle and prioritize projects in a fast-paced and deadline-driven environment.
  • Desire to contribute wherever support is necessary
  • Desire to learn and grow with our company - to put in the time, focus and effort necessary to advance to the next level of their career
  • Work style, pace and drive to make things happen, with a bias for initiating and driving positive results
  • Belief that healthcare reform begins with innovation aimed at making people's lives better
Physical Requirements/Work Environment:
The physical demands described here are representative of those that must be met by an individual to successfully perform the essential duties of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential duties.
  • Work is performed primarily in a traditional office setting, where the employee is regularly required to sit, stand, and demonstrate manual dexterity.
  • Work includes extended periods of time at a desk and computer screen.
  • May be required to occasionally lift up to 25 pounds.
Where You’ll Work:
PursueCare is a startup technology-enabled healthcare management services organization ("MSO") that is addressing the opioid epidemic with an intelligent, convenient, and stigma-free telehealth treatment platform that creates a better experience and outcomes for healthcare providers and patients alike. As traditional opioid addiction treatment models have failed to provide enough access and lasting outcomes for patients, states continue to push for innovative solutions to serve the overwhelming need, particularly across rural and underserved areas. Our vision is to improve access to opioid addiction care and promote better patient engagement/outcomes by providing convenient, private, and stigma-free telemedicine services through a virtual network of on-demand prescribing physicians, addiction counselors, and clinics, as well as other recovery resources and dedicated addiction pharmacy services, right through a browser or smart phone app.
Our platform offers telehealth video conferencing, marketing, care coordination, billing, EHR, reporting, partnerships with referral sources for patients in need of recovery intervention, and ancillary services to addiction treatment practitioners and clinics. We offer greater access and engagement with private, stigma-free medication-assisted treatment (“MAT”) programs and evidence-based protocols, increasing the likelihood practitioners will be able to treat more patients, more consistently, with better outcomes.
We offer all full-time employees unlimited paid time off to allow our team members to properly recharge, competitive salaries, bonus opportunities, equity opportunities, and affordable health coverage with company contributions. We are located in Middletown, CT which is coincidentally right smack in the middle of Connecticut. We offer work-from-home/remote opportunities for certain positions, based upon being able to meet the core competencies and requirements for the position from your location. We pledge to be an Equal Opportunity Employer.