Sr Mgr Provider Admin & Credentialing
Workday$93K – $168K per yearUnited States only
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Job Summary
SUMMARY:
This position is responsible for managing the credentialing process in compliance with agency regulations (Department of Insurance, CMS, DOD/TriCare, NCQA and URAC), 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. Develop performance standards, monitor and analyze unit production and quality statistics to ensure achievement of goals while ensuring personnel resources are appropriately allocated. Participate as a Lead in monthly Provider Network Committee and quarterly Institutional Provider Workgroup meetings, working with Vice Presidents, Directors and Managers from across state and the Enterprise to address issues and improve processes. JOB REQUIREMENTS: