AVP, Provider Credentialing (Remote)

Company: Molina Healthcare
Location: Biloxi
Posted on: September 24, 2022

Job Description:

Job Description Work Location - Remote, Work from Home Job Summary The AVP of Provider Credentialing is a Corporate Network leadership position responsible for leading and managing enterprise-wide credentialing and provider enrollment. - Knowledge/Skills/Abilities

• Oversees and leads enterprise-level credentialing function and -provider enrollment.
• Develops and refines provider adoption strategies related to initiatives impacting provider networks, and assists with coordination health plan provider services staff training.
• Acts as enterprise process leader for provider credentialing and business owner for provider enrollment and credentialing system/platform.
  • Responsible for continuous process improvement in provider enrollment and credentialing processes including standardized "Tool Kits", training program(s), and deployment plan(s).
  • Represents Network Strategy & Services in partnership with Health Care Services, Operations, Quality, and Health Plan business partners to ensure incorporation of Network provider engagement/credentialing strategics to achieve positive operational, financial outcomes and maintain compliance with applicable regulatory requirements.
  • Monitors key performance indicators and metrics to assess provider enrollment & credentialing effectiveness, efficiency and compliance.
  • Oversees the initial credentialing and re-credentialing of all non-delegated providers.
  • Oversees yearly maintenance of all MHI policy and procedures related to credentialing and provider Enrollment. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
  • Leads one or more provider credentialing directors and their team(s).
  • 10 years experience in Healthcare with specific experience in Network Management, Operations or Provider Services.
  • Experience leading and managing employees, preferably in a production-related management role.
  • Demonstrated adaptability and flexibility to changes and response to new ideas and approaches. -
  • Superior problem-solving skills including root cause analysis and prompt resolution.
  • Excellent interpersonal and communication skills (verbal and written).
  • Must have strong PC skills (Word, Excel, Outlook, PowerPoint)
  • Must have strong presentation and leadership skills. - Job Qualifications REQUIRED EDUCATION: Bachelor's Degree in a related field (Healthcare Management, Business Administration, etc.) or equivalent combination of years of experience in lieu of Degree. PREFERRED EDUCATION: Master's Degree in a related field (Healthcare Management, Business Administration, etc.) PHYSICAL DEMANDS: Working environment is generally favorable and lighting and -temperature are adequate. -Work is -generally -performed in an -office -environment in -which -there is -only -minimal -exposure to unpleasant and/or hazardous -working conditions. -Must -have the ability -to sit for long -periods. -Reasonable accommodations -may be -made to -enable individuals with disabilities -to -perform -the -essential function. - To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. #PJCorp #LI-BEMORE

Keywords: Molina Healthcare, Biloxi , AVP, Provider Credentialing (Remote), Other , Biloxi, Mississippi