Posted in General Business 30+ days ago.
Type: Full-Time
This position is responsible for various activities related to support of the Credentialing Operations department. These activities may include serving as the credentialing liaison to Network/Network Operations teams, research of credentialing-related criteria and requirements, outreach to providers regarding application/practice history, and maintenance of resources utilized by the credentialing operations team. Additionally, this position may support the audit and oversight functions for delegated credentialing and serve as the credentialing point of contact during customer and accreditation audits. Incumbent will provide support and backup to the Credentialing Manager and interact with all stakeholders, as needed, to ensure efficient, compliant credentialing processes.
Responsibilities
Minimum of5 years credentialing or health plan contracting (or equivalent) experience.
Knowledge of National Committee for Quality Assurance (NCQA) credentialing standards.
Experience with internet research, review and analysis.
Intermediate knowledge of Microsoft Office applications (Excel, Word, Outlook).
Strong written communication and presentation skills.
Ability to work independently and prioritize activities.
Proven ability to establish consensus, negotiate outcomes, and team build effectively.
General Job Information
Title
Senior Credentialing Research Specialist
Grade
22
Work Experience - Required
Credentialing, Quality
Work Experience - Preferred
Education - Required
High School
Education - Preferred
Bachelor's
License and Certifications - Required
License and Certifications - Preferred
Salary Range
Salary Minimum:
$50,225
Salary Maximum:
$75,335
This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.
This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
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