Provider Enrollment Special Projects at Landmark Health

Remote | Freelance
Landmark Health

Temporary, Provider Enrollment Special Projects

Job Locations: US-Remote

Category: Business Development

Type: Per Diem

Job ID: 2019-3618

Overview

The Credentialing Supervisor is a critical member of the Credentialing team, overseeing credentialing team members and processes of the department. The successful candidate should be detail oriented, with excellent communication skills, experience working in health plan credentialing. Experience managing employees preferred.

Responsibilities

  • Own the end-to-end credentialing processes, by creating and administrating department methods and procedures
  • Manage department metrics by improving turn-around timelines for provider credentialing
  • Work with Manager and VP of Client Operations for department direction
  • Communicate, lead department
  • Lead operational meetings for the department
  • Monitor team’s performance on obtaining primary source verification when indicated
  • Communicate with care providers about impending expirations and requirements for renewal
  • Coordinate with Human Resources and Accounting to obtain and verify credentialing documents
  • Monitor performance of team maintaining credentialing database and CAQH profiles with attention to detail
  • Observe Landmark Health policies and procedures, client contract requirements, state guidelines, and NCQA standards when credentialing providers
  • Responsible for all credentialing file additions, changes, and deletions between renewals, including but not limited to, address changes and personal information updates
  • Facilitate malpractice insurance applications and certificate updates
  • Other administrative duties as determined

Qualifications

  • High school graduate or equivalent
  • Windows-based computer skills
  • Proficiency in Excel
  • 6-10 years in a health care plan operation
  • Credentialing experience a plus

COMPETENCIES

  • Excellent organizational skills
  • Detail-oriented
  • Ability to maintain confidentiality
  • Strong written and verbal communication skills
  • Effective interpersonal skills
  • Good coaching skills

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