Avēsis · 20 hours ago
Credentialing Supervisor
United States
Full-time
Remote
Mid, Senior Level
$56K/yr - $109K/yr
3+ years expAvēsis is a leading provider of supplemental benefits, and they are seeking a Supervisor of Credentialing to lead their Credentialing Department. This role involves providing strategic direction, oversight, and ensuring compliance within the credentialing operations to support the integrity of their healthcare services.
Insurance
Responsibilities
Lead a first-class, metrics-driven credentialing operation maintaining compliant operations while achieving best-in-class turnaround times
Provide leadership, mentoring, training, and coaching to all Credentialing Specialists
Effectively work with internal department and clinical support to identify best practices and opportunities to improve quality performance
Meet with direct reports on a routine basis for one on ones, provide performance feedback, and coach/counsel employees as needed. Document performance when needed. Complete annual performance appraisals and recommend salary adjustments
Keep pace with regulatory changes and work internally to modify systems and processes to mitigate any negative impact
Manage and maintain positive engagement with CVO and other external credentialing vendors
Maintain a comprehensive understanding of healthcare credentialing requirements
Support and Implement department goals and continuous process improvement initiatives
Provide support to the Credentialing Team to ensure adequate performance
Qualification
Required
Bachelor's degree or equivalent education and experience
CPCS Certification required, may be obtained within 6 months of accepting position
3+ years of credentialing experience in a managed care setting
Intermediate skill level in Microsoft Excel
3+ years of experience managing and maintaining provider network databases
As this role is a remote role, you are required to maintain internet service that allows you to complete your essential job duties without issue. Rates of 50 Mbps download and 10 Mbps upload while hardwired and not on a VPN are sufficient
Lead a first-class, metrics-driven credentialing operation maintaining compliant operations while achieving best-in-class turnaround times
Provide leadership, mentoring, training, and coaching to all Credentialing Specialists
Effectively work with internal department and clinical support to identify best practices and opportunities to improve quality performance
Meet with direct reports on a routine basis for one on ones, provide performance feedback, and coach/counsel employees as needed. Document performance when needed. Complete annual performance appraisals and recommend salary adjustments
Keep pace with regulatory changes and work internally to modify systems and processes to mitigate any negative impact
Manage and maintain positive engagement with CVO and other external credentialing vendors
Maintain a comprehensive understanding of healthcare credentialing requirements
Support and Implement department goals and continuous process improvement initiatives
Provide support to the Credentialing Team to ensure adequate performance
Working knowledge of NCQA standards and payer credentialing standards
Working knowledge of best practices for provider data management and maintenance
Knowledge of PSV (primary source verifications), CAQH, OIG (Office of Inspector General) & NPDB (National Practitioner Data Bank)
Working knowledge of credentialing databases to manage, track, and verify provider data
Strong computer, data entry and analysis skills
Collegiality: building strong relationships on company-wide, approachable, and helpful, ability to mentor and support team growth
Initiative: readiness to lead or take action to achieve goals
Communicative: ability to relay issues, concepts, and ideas to others easily orally and in writing
Member-focused: going above and beyond to make our members feel seen, valued, and appreciated
Detail-oriented and thorough: managing and completing details of assignments without too much oversight
Flexible and responsive: managing new demands, changes, and situations
Critical Thinking: effectively troubleshoot complex issues, problem solve and multi-task
Integrity & responsibility: acting with a clear sense of ownership for actions, decisions and to keep information confidential when required
Collaborative: ability to represent your own interests while being fair to those representing other or competing ideas in search of a workable solution for all parties
Preferred
Knowledge of vision or dental industry
1-2 years leadership and performance management experience
Benefits
Excellent medical, dental, supplemental health, life and vision coverage for you and your dependents with no wait period.
Life and disability insurance.
A great 401(k) with company match.
Tuition assistance, paid parental leave and backup family care.
Dynamic, modern work environments that promote collaboration and creativity to develop and empower talent.
Flexible time off, dress code, and work location policies to balance your work and life in the ways that suit you best.
Employee Resource Groups that advocate for inclusion and diversity in all that we do.
Social responsibility in all aspects of our work.
Company
Avēsis
Guiding you to wellness with innovative tools, equitable access, and a personal touch.
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
Sean Slovenski
Chief Executive Officer
Karim Bennis
Executive Vice President, Chief Operating Officer
Recent News
2024-01-03
2023-09-26
Company data provided by crunchbase