Commonwealth Care Alliance is a rapidly growing nonprofit organization providing integrated health care and social support services to people with complex medical needs. Our patients are seniors and persons with disabilities covered under Medicaid or both Medicaid and Medicare. Our innovative care model is nationally recognized for its effectiveness in improving health outcomes for these vulnerable populations.
Our unique care model is empowering for our employees as well as our members. Whether you are a clinical or administrative professional, all of us at Commonwealth Care Alliance receive the satisfaction of knowing our work truly makes a difference. We enjoy a company culture of passionate advocacy in a supportive work environment with opportunities for growth and learning, competitive salaries, and a generous and comprehensive benefit package.
Credentialing Supervisor will oversee the day to day operations of Credentialing Department. This position will direct staff regarding work prioritization, daily questions and challenges and provide a mentoring resource to the team. In addition, the Credentialing Supervisor will monitor the quality of credentialing output through reporting and individual work auditing.
• Assign workload to credentialing team on a daily basis to maximize overall productivity.
• Act as a subject matter expert by answering staff questions as they arise. Empower and educate staff on available resources and strategies to handle future issues independently.
• Train new employees and maintain training documentation. Training documents will be updated frequently as changes occur. Creativity is encouraged to make resources available to staff as clear and useful as possible.
• Perform quality monitoring on staff output by reviewing database and credentialing files; coach staff based on audit results to optimize overall quality.
• Review unclean provider files, coordinate with Credentialing Manager and Medical Director to receive provider approval or to add unclean providers to Credentialing Committee agenda.
• Collaborate frequently with Contracting, Provider Data Management and Medical Affairs departments on key issues and initiatives.
• Become proficient in Key Performance Indicator (KPI) reporting for Credentialing Department related metrics.
• Collaborate with Credentialing Manager on the development and update of Standard Operating Procedures (SOPs) and Policies and Procedures (P&Ps).
• Lead productive team meetings, including drafting agenda and guiding meeting discussion.
Minimum Education Required: Bachelor's Degree or equivalent experience
Minimum Experience Required: 2 years
Minimum Experience: Minimum two years experience in a provider credentialing setting
• Minimum one year experience in a supervisory role
Knowledge, Skills and Abilities • Knowledge of Visual Cactus credentialing database preferred.