[Hiring] Supervisor-Dental Provider Credentialing @USAble Life
Role Description 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.
- 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.
Qualifications
- 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.
Requirements
- 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®).
Benefits
- 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.
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