We use cookies. Find out more about it here. By continuing to browse this site you are agreeing to our use of cookies.
#alert
Back to search results
New

Sr Manager Provider Administration & Credentialing

Health Care Service Corporation
life insurance, parental leave, paid time off, paid holidays, tuition reimbursement, 401(k), remote work
United States, Texas, Richardson
1001 East Lookout Drive (Show on map)
Feb 06, 2025

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.

Job Summary Summary:
This position is responsible for managing the credentialing process in compliance with agency regulations, managing the process of collection and maintenance of professional provider data, and managing credentialing audits. This position is responsible for the development, implementation and maintenance of policies, procedures, workflow processes and developing departmental goals, ensuring the departments meets or exceeds goals, and operational effectiveness.

JOB REQUIREMENTS:

  • Bachelor's Degree and 7 years' experience in a managed care provider contracting, network management or credentialing OR 11 years' experience in a managed care provider contracting, network management or credentialing.
  • Three years management experience. Management skills to cultivate a creative, supportive and innovative environment. Coaching and training skills.
  • Experience in a production environment with a focus on operations, state and federal regulations, industry standards and quality concepts.
  • Experience developing, implementing and managing projects and programs.
  • Experience developing and implementing policies, procedures, processes, and workflows.
  • Knowledge of NCQA, URAC, CMS, and state Department of Insurance regulatory requirements.
  • Analytical skills and experience identifying and resolving workflow and system problems.
  • Written, verbal and interpersonal communication skills. Ability to present clear, concise and accurate information; ability to facilitate diverse groups, and building relationships with employees and external customers.

PREFERRED JOB REQUIREMENTS:

  • Proficiency in data tools (Excel, PowerBI, data mining, data reporting) - HIGHLY PREFERRED
  • Knowledge of HCSC provider systems.
  • Experience developing innovative solutions to ensure objectives are accomplished.

Sponsorship will not be supported for this role.

Hybrid: Work in office 3 days a week, work from home 2 days a week

#LI-LI1

#LI-Hybrid

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

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 https://careers.hcsc.com/totalrewards.

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

HCSC Employment Statement:

We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, 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$90,900.00 - $164,200.00
Applied = 0

(web-7d594f9859-68c9j)