Description
At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.
Join HCSC and be part of a purpose-driven company that will invest in your professional development.
Summary: This position is responsible for managing the credentialing process in compliance with agency regulations, managing the process of collection and maintenance of professional provider data, and managing credentialing audits. This position is responsible for the development, implementation and maintenance of policies, procedures, workflow processes and developing departmental goals, ensuring the departments meets or exceeds goals, and operational effectiveness.JOB REQUIREMENTS:
- Bachelor's Degree and 7 years' experience in a managed care provider contracting, network management or credentialing OR 11 years' experience in a managed care provider contracting, network management or credentialing.
- Three years management experience. Management skills to cultivate a creative, supportive and innovative environment. Coaching and training skills.
- Experience in a production environment with a focus on operations, state and federal regulations, industry standards and quality concepts.
- Experience developing, implementing and managing projects and programs.
- Experience developing and implementing policies, procedures, processes, and workflows.
- Knowledge of NCQA, URAC, CMS, and state Department of Insurance regulatory requirements.
- Analytical skills and experience identifying and resolving workflow and system problems.
- Written, verbal and interpersonal communication skills. Ability to present clear, concise and accurate information; ability to facilitate diverse groups, and building relationships with employees and external customers.
PREFERRED JOB REQUIREMENTS:
- Proficiency in data tools (Excel, PowerBI, data mining, data reporting) - HIGHLY PREFERRED
- Knowledge of HCSC provider systems.
- Experience developing innovative solutions to ensure objectives are accomplished.
Sponsorship will not be supported for this role.
Hybrid: Work in office 3 days a week, work from home 2 days a week
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Compensation: $90,900.00 - $164,200.00
Exact compensation may vary based on skills, experience, and location
HCSC Employment Statement:
We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
To learn more about available benefits, please click https://careers.hcsc.com/totalrewards
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