Excellent employment opportunity!
CareMore is looking for dynamic individuals to join our team!
CareMore is a leading healthcare system specializing in providing a complete, pro-active health care experience to Senior Americans. CareMore strongly believes in our innovative and caring vision to lead the next generation of health care and we look for candidates that share in our passion.
As a leader in senior healthcare for over 20 years, our vision is to significantly improve the lives of Medicare recipients by employing a dedicated staff of professionals who are passionate about changing lives. When you join CareMore, we’ll give you every opportunity to make a real difference.
Be More with CareMore.
CREDENTIALING MANAGER
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Job Description:
The Credentialing Manager will manage and oversee all credentialing and recredentialing operations at CareMore Health Plan. The Credentialing Manager will provide leadership and support to the staff assigned to the organization’s Credentialing Department and have responsibility for facilitating quality related activities on a company-wide basis. The Credentialing Manager will assist the organization in its preparation for applicable portions of CMS, NCQA and any other accreditation or licensing processes elected by the health plan.
Essential Duties and Responsibilities Include:
Essential duties and responsibilities include but are not limited to:
- Facilitates the development, implementation and annual review of the CareMore Credentialing Program
- Facilitate meetings and activities of the Credentialing Committee.
- Coordinate and monitor the activities and proceedings of the Credentialing Committee including oversight of preparation of meeting materials, minutes and reports.
- Identify, assess and monitor review opportunities related to applicants as appropriate.
- Perform necessary duties for follow up actions such as correspondence as directed by the Credentialing Committee.
- Direct and/or perform delegation oversight activities for entities to be delegated for credentialing and recredentialing.
- Facilitate the development of policies and procedures related to credentialing and recredentialing activities.
- Make certain that credentialing is conducted in a timely manner, not timeframes set by policy.
- Ensure completed files are presented to the Credentialing Committee.
- Perform quality improvement review activities on Credentialing functions to measure and drive improvement to processes and staff development.
Supervisory Responsibilities:
Supervises staff and carries out supervisory responsibilities that may include but are not limited to: interviewing, hiring and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.
Education and Experience:
- High school diploma or general education degree (GED).
- Baccalaureate degree in health related field preferred.
- Experience with CMS and NCQA standards required; Understanding of continuous quality improvement processes required.
- Certification as Credentialing Professional preferred.
- Completion of related credentialing ongoing education required. Computer literacy with proficiency and expertise in Microsoft Office, including software applications for WORD, EXCEL, and ACCESS.
Compensation/Benefits:
CareMore offers a comprehensive benefits package to include medical, dental, vision, life, long term disability, flexible spending accounts, 401(k), PTO, paid holidays and much more.
AA/EOE M/F/D/V
Watch how our CareMore Employees care more, in the video below.
