Credentialing Supervisor

4 weeks ago


Stamford, Connecticut, United States Partnership HealthPlan of California Full time
Job Summary

We are seeking a highly skilled Credentialing Supervisor to join our team at Partnership HealthPlan of California. As a key member of our healthcare operations team, you will be responsible for overseeing the day-to-day operations of our credentialing functions, ensuring the highest level of accuracy and timeliness in credentialing processes.

Key Responsibilities
  • Supervise the daily functions of the Provider Relations Credentialing Specialist staff, ensuring compliance with National Committee for Quality Assurance (NCQA) standards.
  • Provide leadership, direction, training, and support to staff, promoting a positive attitude, teamwork, and fun in the workplace.
  • Monitor staff productivity, accuracy, and service delivery, providing monthly performance feedback and conducting annual performance evaluations.
  • Ensure timely audits of delegated credentialing activities and oversee the quality of materials presented at Credentialing meetings.
  • Responsible for credentialing delegation oversight, ensuring delegated entities submit required documents on schedule and follow-up as required.
Requirements
  • Bachelor's degree in Healthcare, Business, or related field, and minimum three (3) years of experience in healthcare, credentialing, or provider relations.
  • Previous supervisory experience a plus, with knowledge of medical providers and credentialing requirements.
  • Working knowledge of NCQA credentialing standards, credentialing practices, Medi-Cal managed care, and business software applications.
What We Offer

We offer a competitive salary range of $93,000 to $117,113.58, depending on experience. If you are a motivated and detail-oriented individual with a passion for healthcare operations, we encourage you to apply for this exciting opportunity.



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