In this role as Provider Compliance and Policy Manager, you will manage and coordinate audits on behalf of the Provider Credentialing department. Review and provide complete and accurate documentation and results to auditors and government/regulatory agencies as requested, consult on potential issues, and formulate Wellmark's response. Support timely completion of any recommended actions. Interpret state and federal regulations as well as Blue Cross Blue Shield Association (BCBSA) changes and provide impact to stakeholders regarding changes which may impact Provider Credentialing. Support the management, coordination, and completion of Credentialing regulatory changes and projects. Collaborate and work closely with Legal, Compliance, and Government Relations in the interpretation of regulations in support of business-specific planning and execution. Complete the annual update of department policies and procedures and own the creation of policies/procedures in PolicyTech.
Required:
An Equal Opportunity Employer
The policy of Wellmark Blue Cross Blue Shield is to recruit, hire, train and promote individuals in all job classifications without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or any other characteristic protected by law.
Applicants requiring a reasonable accommodation due to a disability at any stage of the employment application process should contact us at careers@wellmark.com
Please inform us if you meet the definition of a "Covered DoD official".
At this time, Wellmark is not considering applicants for this position that require any type of immigration sponsorship (additional work authorization or permanent work authorization) now or in the future to work in the United States. This includes, but IS NOT LIMITED TO: F1-OPT, F1-CPT, H-1B, TN, L-1, J-1, etc. For additional information around work authorization needs please refer to the following resources: Nonimmigrant Workers and Green Card for Employment-Based Immigrants
Wellmark supports and expects the responsible use of AI for our workforce! We welcome the responsible use of these tools by job seekers as well and are interested in learning from you; you will have an opportunity in the application process to share which tools you used and how you applied them.
Provider Compliance & Policy Manager • Des Moines, IA, US
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