Delegation Oversight Coordinator Credentialing

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Job Summary

This position is responsible for leading, coordinating and participating 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. The position also develops audit tools based on Credentialing / Re-credentialing operations, state and federal regulations, conducts the reviews in accordance with accreditation standards and Credentialing guidelines. Creates reports regarding audits, and analyzes tracks and trends audit findings. Develops and monitors corrective actions and provides 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 file 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 Power Point, Visio and Access.

College level courses or certification in project management.

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Pay Transparency Statement :

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting .

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

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.

Base Pay Range

$49,800.00 - $110,000.00

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

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For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities.

Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment.

HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants.

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Please note that only requests for accommodations in the application process will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions.

Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas,

Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association

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