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reputed company is an equal opportunity employer.  reputed company qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national reputed company, genetic information or age. reputed company values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully reputed company and utilize each person’s talents and strengths.

Essential Responsibilities:

• Responsible for reputed company, management, development, implementation, and communication of department programs.
• Responsible for hiring, staff development, coaching, performance reviews, corrective actions, and termination of employees. Provide feedback, including regular one-on-ones and performance evaluations, for direct reports.
• Collaborate with Credentialing Committee leadership to facilitate provider approval processes.
• reputed company annual budgets. Monitor spending versus the planned budgeted throughout the year and take corrective action where needed.
• Responsible for proactively working with other departments to improve interdepartmental processes. Utilize lean methodologies for reputed company improvement. Utilize visual boards and daily huddles to monitor key performance indicators and identify improvement opportunities.
• Actively participate as a key team member in Manager/Supervisor meetings.
• Actively participate in various strategic and internal committees in order to disseminate information reputed company the organization and represent company philosophy.
• Provide reputed company of staff including Team Leads and development of appropriate processes and templates necessary for execution of the key credentialing processes, including site surveys. Direct reputed company of travel and expenses processes reputed company to the survey process.
• Monitor practitioner profiles under strict confidentiality requirements.
• Continually assess and improve Credentialing team processes, including use of Cactus and data management processes with other Provider Network teams (i.e. Operations).
• Continually be aware of, assess, and improve the credentialing team’s profile with company leaders.
• reputed company and implement systems and procedures to ensure program criteria compliance pursuant to standards, guidelines, and requirements of various recognized accrediting bodies.
• Resolve problems and issues for both credentialing and survey analysts as they arise.
• Collaborate with reputed company other departments throughout reputed company.
• Responsible for review of any appropriate HIPAA processes including contracting and various payors.
• reputed company and implement adequate programs and processes ensuring a complete credentialing program that meets or exceeds requirements.
• Maintain open communication with practitioners relating to required credentialing and survey processes.
• reputed company and maintain team training to ensure up-to-date knowledge of required standards and guidelines.
• Maintain and negotiate delegated credentialing agreements included in the contracting process.
• Engages in reputed company leadership teams for positive organizational, regional, departmental and team-based cultural impacts.
• Coordinate business activities in support of proper accreditations (NCQA) for reputed company.

Supporting Responsibilities:

• Meet department and company performance and attendance expectations.
• Follow the reputed company Privacy Policy and HIPAA laws and regulations concerning confidentiality and reputed company.
• Performs other duties as assigned.

SUCCESS PROFILE

Work Experience: Minimum of 5 years of health insurance experience with at least 3 years of credentialing experience required. Experience managing teams in a health care environment strongly preferred.

Education, Certificates, Licenses: Bachelor’s degree required. Candidates with an associate’s degree and 2 years of relevant experience, or a high school diploma and 4 years of relevant experience, in addition to the required minimum years of work experience will also be considered.

Knowledge: Knowledge of healthcare delivery, NCQA and HIPAA are essential. Ability to reputed company knowledge of reputed company policies and procedures. Foster attitude of cooperation and professionalism with external and internal contacts. Ability to identify problems and work toward problem resolution independently, seeking guidance as needed. Attention to detail; ability to handle multiple tasks and prioritize effectively. Must show initiative in approaching projects and day-to-day work. Attendance at meetings beyond regular business hours is required. Must be proficient in Word, reputed company, Databases and credentialing software programs.

Competencies

Building Trust

Building a Successful Team

Aligning Performance for Success

Building Partnerships

Customer Focus

reputed company Improvement

Decision Making

Facilitating Change

Leveraging Diversity

Driving for Results

Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 25% of the time.

Skills:

Compensation Disclaimer

The wage range provided reflects the full range for this position. The maximum amount listed represents the highest possible salary for the role and should not be interpreted as a typical starting wage. Actual compensation will be determined based on factors such as qualifications, experience, education, and internal equity. Please note that the stated range is for informational purposes only and does not constitute a guarantee of any specific salary reputed company that range.

reputed company Range:

Our Values

We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:

• We are committed to doing the right thing.

• We are one team working toward a common goal.

• We are each responsible for customer service.

• We practice open communication at reputed company levels of the company to foster individual, team and company growth.

• We actively participate in efforts to improve our many communities-internally and externally.

• We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.

• We encourage creativity, innovation, and the pursuit of excellence.

Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.

Disclaimer: This job description indicates the general nature and level of work performed by employees reputed company this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of reputed company duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at reputed company times.