Health Risk Management Specialist

Fort Lauderdale, Florida

Hayes Locums
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Physician recruitment agency and healthcare locums staffing firm focused on providing excellent service to our practitioners and clients. We have won multiple industry awards including Best Places to Work, and Diamond Award Winner for Best of Staffing Client and Talent Satisfaction.

Schedule: M-F in-office with a hybrid remote day after 90-days (typically on Tuesdays)

Job Summary:

As a HRP Specialist, you will play a key role on Hayes' risk management team by evaluating physicians/advanced practitioners (providers) in accordance with Hayes Locums' Risk Management Guidelines. Additionally, the HRP Specialist is responsible for responding to inquiries from other various Hayes departments related to a provider's qualifications.

The role focuses on assessing all aspects of a provider's application and supporting documents (file), including education/work history, hospital privileges, medical board actions and investigations, malpractice/National Practitioner Data Bank history, medical licenses, etc. Upon review, the HRP Specialist will make determinations regarding the provider's eligibility to work on behalf of Hayes. These findings and determinations will then be documented in a brief write-up summary.

The HRP Specialist works closely with other Hayes support departments (Quality Assurance, Licensing, Credentialing) and Sales teams to ensure all relevant information is received and documented during the provider review process.

Effective communication skills are a must. An ideal candidate would enjoy a position that requires attention to detail, critical thinking and problem solving, accuracy, and organization.

Essential Duties and Responsibilities:

  • Review medical providers' files accurately and promptly, ensuring they meet the required Hayes Locums Risk Management Guidelines and/or identifying deficiencies.
  • Effectively communicate with the proper department(s) when additional information is required to complete a provider's file and following up until all items are received.
  • Escalate files to Risk Management leadership when certain issues/deficiencies are discovered.
  • Monitor provider data entered in MD Staff for accuracy.
  • Respond to inquiries from/educate Sales consultants related to a provider's eligibility.
  • Be receptive to coaching/feedback.
  • Assist with developing and maintaining department training and reference materials.
  • Meet monthly KPI goals pertaining to quantity and accuracy of reviewed files.
  • Perform any additional tasks needed to efficiently complete the file review process.
  • Perform miscellaneous job-related duties as assigned

Education and/or Work Experience Requirements:

Education Bachelor's Degree or equivalent combination of education and work experience.

Experience Prior experience in credentialing, clinical/medical environment, or similar roles

Skills:

  • Excellent verbal and written communication
  • Detail oriented and critical thinking
  • Proficiency in Microsoft 365 (Excel, Power Point, Word, Outlook)
  • Proficiency in Salesforce and MD-Staff (preferred)
  • Strong time management skills
  • Ability to organize and prioritize work
  • Adaptability to new/updated processes
  • Ability to take direction and apply learning
Date Posted: 09 April 2025
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