Must-Have Skills
Bachelor’s Degree in BusinessHealth AdministrationPublic Administration or equivalent experience required. If equivalent experiencehigh school diploma required.4 years of progressive experience required.2 years of supervisory experience required.Familiarity with specialty health plans (HMOPPOPOS and related plans) required.Proficient with Microsoft Officeincluding AccessWordExcel and Power Point.Ability to planassignsupervise and evaluate the work of othersand to monitor goalsobjectivesdeadlines and priorities.Ability to manage multiple projects effectively while facilitating group success.Ability to analyzeinterpretand synthesize a wide range of informationincluding legal and contract languagepoliciesstandards and guidelines.Ability to analyze complex data related to credentialing.Knowledge of Credentialing/re-credentialingdelegation oversightNCQAURAC and managed care experience (MedicaidMedicareand Commercial) required.Knowledge of the performance improvement process.The ability to think strategicallyimplement tactically and the ability to position the organization for the future.Preferred knowledge of CAQH.Certified Provider Credentialing Specialist (CPCS) preferred.
Nice-to-Have Skills
CAQHCPCS
Tools & Platforms
Microsoft OfficeAccessWordExcelPowerPoint
Hard Skills
Microsoft OfficeAccessWordExcelPowerPointCredentialingNCQAURACCAQHCPCSData analysis
Soft Skills
LeadershipTraining and developmentCommunicationTeam managementAnalytical thinking
Certifications
Preferred
Certified Provider Credentialing Specialist (CPCS)
Keywords for Your Resume
Associate Manager-CredentialingCredentialingNCQAURACCAQHCPCSCredentialing/re-credentialingdelegation oversightcredentialing staffpoliciesproceduresdata analysiscompliancemultiple projectsclinical credentialingCAQH knowledgeMediCareMedicaidMedicareCommercialMicrosoft OfficeAccessWordExcel
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