Description
At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career.
Come join us and be part of a purpose driven company who is invested in your future!
Job Summary ***This is a hybrid opportunity that will work from the office 3 days a week. Must live in a commutable distance to the Richardson, TX (Dallas) office or Tulsa, OK office.****Sponsorship will not be provided for this role.*
This position is responsible for leading, coordinating and participating in Credentialing Delegation oversight audits of HCSC's vendors, service providers, medical groups and/or delegated subcontracted providers reviewing adherence to regulatory and contractual requirements. The position also develops audit tools based on Credentialing/Re-credentialing operations, state and federal regulations, conducts the reviews in accordance with accreditation standards and Credentialing guidelines. Creates reports regarding audits, and analyzes tracks and trends audit findings. Develops and monitors corrective actions and provides feedback to practitioners on performance.
Note: Currently no travel requirements, but may change in the future.
Required Job Qualifications:
- Associate Degree in Business or Medical OR 3 or more years' experience in a managed care environment.
- 2 years in a leadership role that includes direct accountability and responsibility and direction of staff.
- 4 years' experience in directly involved in Credentialing operations performing delegated oversight activities
- 4 years auditing Credentialing file or Credentialing operational experience
- Project Management skills and experience.
- Knowledge of regulatory/accreditation requirements and standards (Department of Insurance, NCQA, URAC).
- Verbal and written communication skills.
- Organizational skills and the ability to handle multiple priorities.
- PC proficiency to include Word, Excel, PowerPoint, Adobe Acrobat, and Outlook.
- Ability to travel (up to 30-40%) Including overnight stays
Additional Job Qualifications:
- 4 years specific DELEGATION experience EXPLICITLY REQUIRED
- Professional working knowledge of Excel and Adobe Acrobat HIGHLY PREFERRED
- Experience with PowerBI
- Bachelor Degree in Business or Medical-related fields
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We encourage people of all backgrounds and experiences to apply.
Even if you don't think you are a perfect fit, apply anyway - you might have qualifications we haven't even thought of yet.
*Sponsorship will not be provided for this role.*
Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!
HCSC Employment Statement:HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
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