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Delegation Oversight Coordinator Credentialing
Delegation Oversight Coordinator CredentialingNetwork Business Solutions • Richardson, TX, US
Delegation Oversight Coordinator Credentialing

Delegation Oversight Coordinator Credentialing

Network Business Solutions • Richardson, TX, US
13 hours ago
Job type
  • Full-time
Job description

Overview

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Responsibilities

  • Lead, coordinate and participate in Credentialing delegation oversight audits of HCSC's vendors, service providers, medical groups and / or delegated subcontracted providers, reviewing adherence to regulatory and contractual requirements.
  • Develop audit tools based on Credentialing / Re-credentialing operations, state and federal regulations, and accreditation standards and Credentialing guidelines.
  • Conduct reviews in accordance with accreditation standards and Credentialing guidelines; create reports regarding audits and analyze trends in audit findings.
  • Develop and monitor corrective actions and provide feedback to practitioners on performance.

Required Job Qualifications

  • Associate Degree in Business or Medical OR 3 or more years' experience in a managed care environment.
  • 2 years in a leadership role that includes direct accountability and responsibility and direction of staff.
  • 4 years' experience in directly involved in Credentialing operations performing delegated oversight activities.
  • 4 years auditing Credentialing files or Credentialing operational experience.
  • Project management skills and experience.
  • Knowledge of regulatory / accreditation requirements and standards (Department of Insurance, NCQA, URAC).
  • Verbal and written communication skills.
  • Organizational skills and the ability to handle multiple priorities.
  • PC proficiency to include Word, Excel, PowerPoint, Adobe Acrobat, and Outlook.
  • Ability to travel (up to 30-40%), including overnight stays.

    • Preferred Job Qualifications

  • Bachelor Degree in Business or Medical.
  • Knowledge of PowerPoint, Visio and Access.
  • College level courses or certification in project management.

    • Compensation

    Compensation : $49,800.00 - $110,000.00

    Exact compensation may vary based on skills, experience, and location.

    Employment Statement

    HCSC Employment Statement : We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

    To learn more about available benefits, please visit the total rewards page : https : / / careers.hcsc.com / totalrewards

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    Credentialing Coordinator • Richardson, TX, US