Offer summary
Qualifications:
Prior work experience and knowledge of Long Term Care, Medical, Behavioral Health, and Ancillary providers, Bachelor’s degree in a healthcare, social work, quality management or related field or equivalent experience; 3-5 years managed health experience.
Key responsabilities:
- Verify provider data, conduct delegation oversight audits, review incoming provider applications, maintain accurate provider information in database and spreadsheets
- Document/track credentialing decisions, coordinate audit reviews for compliance, prepare provider files for committee review, distribute reports according to regulatory standards