Supervise the day-to-day operations of Partnership HealthPlan of California’s (PHC) credentialing functions. Provide leadership, support, training, and direction to the Provider Relations Credentialing Specialist staff. Ensure the highest level of accuracy and timeliness of credentialing functions, including delegation oversight.. Train and monitor staff in the delivery of excellent customer service.
Education and Experience
Bachelor’s degree in Healthcare, Business, or related field; and minimum three (3) years of experience in healthcare, credentialing, or provider relations; or equivalent combination of education and experience. Previous supervisory experience a plus. Knowledge of medical providers and credentialing requirements.
Special Skills, Licenses and Certifications
Working knowledge of NCQA credentialing standards, credentialing practices, Medi-Cal managed care and business software applications. Ability to implement Medi-Cal policies and procedures. Valid California driver’s license and proof of current automobile insurance compliant with PHC policy are required to operate a vehicle and travel for company business.
Performance Based Competencies
Excellent oral and written communication skills. Excellent organization skills with the ability to prioritize assignments, maintain accurate records, and meet deadlines. Ability to use good judgment in making decisions within scope of authority and handle sensitive issues with tact and diplomacy.
Work Environment And Physical Demands
Ability to use a computer keyboard. More than 30% of work time is spent in front of a computer monitor. When required, ability to move, carry, or lift objects of varying size, weighing up to 35 lbs.
All HealthPlan employees are expected to:
IMPORTANT DISCLAIMER NOTICE
The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.