Supervisor - Dental Provider Credentialing

Supervisor-Dental Provider Credentialing - Remote

Job Category: Provider Network Management

Requisition Number: SUPER002200

• Full-Time
• Remote

• Locations

  Showing 1 location

  Jacksonville, FL 32246, USA

Job Details

What We Offer You:

• A culture that values employees and celebrates, empowers, and inspires a diverse workforce
• Outstanding and affordable benefits package
• PTO provided at date of hire
• 11 paid holidays
• 401(k) with up to 6% match; fully vested from day 1
• Remote opportunities with company-provided equipment
• Team-oriented, collaborative group of peers
• Career advancement opportunities
• Tuition Reimbursement
• Employee Assistance Program
• Inclusion Council and Employee Resource Groups
• Recharge Days and Volunteer Time Off 
• This is a remote position.

Life Takes You Places!  Are you ready to join us?

The starting base salary range for a Supervisor-Dental Provider Credentialing is $63,000 to $90,000.  Actual salaries will vary by geographic location and are based on factors such as candidate’s qualifications, experience, skills, competencies, and company tenure & equity. In addition to base compensation, this role is eligible for a annual incentive plan based on company performance and individual performance.

Supervisor, Dental Provider Data Maintenance & Credentialing Overview

The Supervisor, Dental Provider Data Maintenance & Credentialing supervises the daily tasks of the Provider Data Maintenance & Credentialing Specialist I. This role works with outside vendors including but not limited to CVO, Dental Directors, Print and Mail Services.

Essential Duties

• Monitors workflow within the team and with outside vendors such as the CVO and identifies opportunities for process improvements. Coaches and provides assistance and feedback to staff as needed
• Researches, plans, and prepares departmental reports to ensure accuracy and efficiency of the team's data entry and adherence to NCQA protocols for credentialing and re-credentialing
• Works directly with internal and external auditors and follows up on any recommended actions.
• Works directly with Dental Director and Credentialing Committee attendees to ensure all files are reviewed, signed off on and any follow-up action completed
• Facilitates all mailings associated with re-credentialing to ensure that NCQA guidelines relative to timeliness are being met
• May perform other duties, including the daily functions of the credentialing team as assigned
• Monitors and recommends adjustments to workflow processes and staff assignments
• Prepares performance reviews, and administrative action documentation, and reviews with staff as necessary
• Coordinates audit reviews as necessary and follows up on any action items
• Manages reports to monitor efficiency and quality review
• Prepares the monthly agenda for Credentialing Committee meeting
• Makes all preparations for the Credentialing Committee Meeting and attends and creates meeting minutes
• Drafts letters for all tabled cases and prepares check requests for the attendees' stipends

Required Knowledge, Skills, and Abilities

• Knowledge of general credentialing processes
• Knowledge of CVOs and NCQA Credentialing Guidelines  
• Advanced MS Office skills, particularly Excel
• Excellent verbal and written communication skills including the ability to compose professional correspondence
• Demonstrated leadership skills and the ability to assist and guide others
• Ability to supervise staff using appropriate tools and techniques
• Ability to maintain attention to detail and a low error rate
• Ability to prioritize tasks and work within time constraints

Required Education and Experience

• Bachelor’s Degree or related experience
• 3 to 5 years’ provider data maintenance & credentialing experience
• Credentialing Delegation Oversight experience
• Minimum 1 year of management experience
• Or, equivalent military experience

Preferred Education and Experience

• 3 years as a Credentialing Specialist II
• Certified Provider Credentialing Specialist (CPCS®)