Senior Credentialing Representative
About The Position
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So, when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.SM It's that time, isn't it? You're ready for the next step forward and an opportunity to build on your skills. And it just so happens that there's never been a better time to become a part of the team at UnitedHealth Group. We're building and maintaining extensive provider networks to serve our customers. Our goal is to attract and secure relationships with the best in every specialty and every community. As a senior member of our provider credentialing team, you'll help us vet and document the competencies of physicians and other providers in our networks. As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 6 leader. Finding and securing the best providers for our growing networks is helping UnitedHealth Group improve the lives of millions. Join us. Learn more about how you can start doing your life's best work. Positions in this function are responsible for all activities associated with credentialing or re-credentialing physicians and providers. Includes processing provider applications and re-applications including initial mailing, review, and loading into the database tracking system ensuring high quality standards are maintained. Conducts audits and provides feedback to reduce errors and improve processes and performance. Responsible for the development of credentialing policies and procedures. May oversee primary source verification activities. Employees in jobs labeled with ‘SCA’ must support a government Service Contract Act (SCA) agreement. Schedule: Full time 40 hours, Monday-Friday, 7:30AM-4:00PM Location: This role is Remote Nationwide You will enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.
Requirements
- High School Diploma/GED
- 2+ years of health care provider credentialing experience
- 2+ years of experience working with compliance workflows and processes, including NCQA policies and practices
- Intermediate level of proficiency with MS Excel and Word
- All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Responsibilities
- Help process provider applications and re-applications including initial mailing, review and loading into the database tracking system
- Conduct audits and provide feedback to reduce errors and improve processes and performance
- Demonstrate great depth of knowledge/skills in own function and act as a technical resource to others
- Solve complex problems on own; proactively identify new solutions to problems
- Act as a facilitator to resolve conflicts on team
- Perform as key team member on project teams spanning more than own function
- Get ready for some significant challenge. This is a performance driven, fast paced environment where accuracy is key. You'll be helping us confirm to very exacting standards such as NCQA, CMS and state credentialing requirements
- Work does not usually require established procedures
- Works independently
- Mentors’ others
- Acts as a resource for others
- Coordinates others' activities
Benefits
- a comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
High school or GED
