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Manager, Credentialing

Austin, Texas Apply Now Job ID 1153979 Category Provider Data Management Organization Centene Corporation Schedule Full-time
Description:
Position Purpose: To perform duties to ensure the on going credentialing and re-credentialing of providers

Oversee the credentialing and re-credentialing of all physicians, mid-level practitioners and organizational providers according to the plan specifications for multiple business units
Collaborate with the health plans and various departments on network expansion efforts, large claims and contract amendment projects and various related initiatives
Ensure compliance with NCQA and DHHS credentialing requirements and participate in activities related to plan NCQA accreditation
Identify process improvement opportunities to decrease cost, improve quality and increase efficiency within the department
Facilitate Credentialing Committee activities and serve on Quality Improvement Committees, when needed
Review and update credentialing program descriptions, policies and procedures
Oversee the development and implementation of quality initiatives to achieve healthy outcomes for assigned projects
Ability to travel
Qualifications:

Education/Experience: Bachelor's degree in related field or equivalent experience. 4+ years of credentialing or provider data experience. Experience in a managed care or insurance environment.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
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