Supervisor, Provider Operations - Credentialing - Remote

Sentara Health

18h • Remote

About The Position

Sentara Health Plans is currently hiring for a Supervisor, Provider Operations - Credentialing. The primary role of the Team Coordinator is to manage the day-to-day activities regarding provider data management and credentialing. This position serves as a subject matter expert and will help support, quality assurance, internal and external auditing of the key processes, system compliance and acceptance testing, and process improvements designed to increase operational effectiveness. This position will also be responsible for the documentation of new policies and procedures, the development and maintenance of training materials, and assistance with onboarding new staff. Sentara Health Plans provides health plan coverage to close to one million members in Virginia. They offer a full suite of commercial products including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and Medicaid enrollees. Their quality provider network features a robust provider network, including specialists, primary care physicians and hospitals. They offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services—all to help members improve their health. Sentara Health is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider that has been in business for over 131 years, offering hundreds of sites of care including 12 hospitals, PACE, home health, hospice, medical groups, imaging services, therapy, outpatient surgery centers, and an 858,000 member health plan. The people of the communities that they serve have nominated Sentara “Employer of Choice” for over ten years. U.S. News and World Report has recognized Sentara as having the Best Hospitals for 15+ years. Sentara offers professional development and a continued employment philosophy!

Requirements

• Bachelor's degree OR a minimum of 3 years' experience in healthcare insurance working with a provider, network, or contract data; OR a combination of education and experience, which would provide an equivalent background.
• 3 years' experience in Healthcare.

Nice To Haves

• Health plan experience is preferred.
• Understanding health claims processing is a plus.

Responsibilities

• Manage the day-to-day activities regarding provider data management and credentialing.
• Serve as a subject matter expert.
• Support quality assurance, internal and external auditing of the key processes.
• Support system compliance and acceptance testing.
• Support process improvements designed to increase operational effectiveness.
• Responsible for the documentation of new policies and procedures.
• Responsible for the development and maintenance of training materials.
• Assist with onboarding new staff.
• Manage a team of up to 10 to 14 credential specialists I and II.

Benefits

• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to $10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down – $10,000
• Reimbursement for certifications and free access to complete CEUs and professional development
• Pet Insurance
• Legal Resources Plan
• Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager