This job was last updated on October 13, 2025 5:10 PM.

Under the direct supervision of Vice President, Provider Relations, and with general responsibility to the Provider Relations division, this position is responsible for accurate and timely provider (re)credentialing support, and computerized file maintenance.

Under the general direction and guidance of the Director, Provider Relations, and through specific direction provided by the person for whom work is performed:

1. Serve as liaison for providers in (re)credentialing process. Assist in resolving problems on a timely basis.
2. Initiate (re)credentialing process upon receipt of application. Review provider and primary source responses. Refer all responses not meeting BHS credentialing criteria to Vice President, Provider Relations.
3. Perform National Practitioner Data Bank queries and internet state licensure board verifications.
4. Maintain computerized provider system, including preparing data conversions for network providers, and entering current credentialing/quality assurance information.
5. Verify and update provider information upon request or receipt of incorrect provider claim(s).
6. Assist in preparation and set-up of Provider Relations meetings and panels.
7. Prepare reports as requested.
8. Attend quarterly credentialing committee meetings, as requested.

Work Designation

• Behavioral health doctors, psychiatrists, psychologists, social workers, psych hospitals, and substance abuse – building that network so they do provider recruiting and rate negotiations, cold call development to providers that don't know them.
• They handle one-time agreements/single case agreements.
• Provider relations, Provider Contracting, Insurance background.
• Network Management, facility contracting.
• Someone with sales and doesn't take no for an answer, great personality, high-functioning anxious person does well, not debilitating anxiety – it pushes her to do more.
• Someone that is a good multitasker, is a go-getter, and thrives in a busy work environment.
• Someone who learns quickly, not a micro manager, doesn't want to have to direct them a lot.
• She has 7 people right now, and adding an 8th is even more; they have credentialing folks as well, growing department, and her last hire didn't have any experience but she was sharp, fast learner, had some office/admin background.
• Fine with healthcare experience, just not someone who's been in a real small environment.
• $60k-$64k, and they have a bonus incentive as well they can offer, and it's between $3k and $4k bonus.
• Wouldn't try to poach a true sales person, but someone that had previous sales experience.
• Her background was advertising sales, but has a psych degree. Not afraid to pick up the phone and call.
• They manage the mental health benefits for self-funded groups nationwide; they're building a network of providers to refer members to.
• Be a liaison for them, getting in-network, and then provider retention, being able to maintain the providers, and the last hire came from a dental practice in a large health system.
• Practice Manager with critical thinking skills, creative, being able to come up with a competitive counter-offer for negotiating and negotiating rates, can analyze the network and say I can't do that and here's what we can do.

Strong attention to detail when typing is BIG!

Principal Duties & Responsibilities

• Past hire: project coordinator, one was case manager, business manager, running provider offices, credentialing piece, and that experience as well.
• Innovative, critical thinker, outgoing, and she can train on this piece, it's not a hard train.
• They brought one that had experience with PPO and providers and provider offices, but she had so much experience that bringing her into our small world because she came from a larger organization, and they're smaller and are responsible for more.

Pay and Schedule

• Full-time, M-F, 8-5
• $20-23/hr