Job Descriptions
Serves as a resource to assist with contracting, provider education, escalated billing and policy issues.
Who are our Provider Relations Consultants?
A method Provider Relations Consultants are employing for provider engagement.
What are the Provider Relations Seminars?
This person oversees professional contracts in Northern Utah and Idaho.
Who is Brenda
Process required by CMS & Accrediting bodies.
What is credentialing?
These are produced in both printed and online form.
What are Provider Directories?
This person reviews provider applications, analyzes provider networks and negotiates rates with providers
What is a contractor
This department performs Initial & Recredentialing activities for all participating facilities & providers.
Who is the Credentialing Department?
The person oversees the intake of provider applications and inputs them in the SmartTracker
Who is MJ.
Recredentialing must be completed every ___ years.
What is every three years?
The primary external contact for our network responsible for building relationships with our healthcare providers.
Who are our Provider Relations Consultants?
This person coordinates contracts, W-9 and emails from and for MHC
Who is Nahui
This department negotiates & monitors Delegate Agreements,
Who is the Credentialing Department?
What network is currently offered to people who just reside in Salt Lake County?
What is U Health Plus
Initial credentialing must occur __
What is prior to a facility/provider’s participation in a network
Contact ID's are assigned to vendor records by this team.
Who are the Provider Data Management Coordinators?
Maintains the integrity of our provider and vendor data.
Who are our Provider Data Manager Coordinators?
This Department recently completed an intitiative to transfer provider applications from low tech paper and pdf to an on-line application.
What is the Contracting Department.
What new Network or plan will begin July 01, 2024.
What is Healthy U CHIP
Once a provider becomes contracted, this next step occurs.
What is complete a CAQH/Facility application?
Shows us provider network participation status.
What is Provider Genie?
This role is responsible for Delegation Audits and Oversight.
What is a Sr. Provider Credentialing Consultant?
This Department is working on developing a Children's Health Insurance Program provider network which will begin July 01, 2024
What is the Contracting Department
What does the abbreviations H.O.M.E mean
Healthy Options Medical Excellence
A provider or facility is considered an in-network provider as of this date.
What is Credentialing Approval date?
The initial point of contact for escalated inquiries from internal departments for billing and policy or service issues.
Who is the Provider Internal Specialist?