Credentialing Manager

🕒 il y a 19 jours

🗽 New York – Distant

🗽 New York – Remote

💵 $80 000 - $90 000 / an

⏰ Temps Plein

🟡 Intermédiaire

🟠 Senior

👔 Manager

🦅 Parrain de Visa H1B

Cette entreprise a parrainé des visas H1B par le passé.

👻 Score fantôme 1%

Ce que ça veut dire : la probabilité que cette offre reste ouverte sans recrutement actif.Comment le lire : 60 % ou plus, on pense que c'est une offre fantôme. Un score plus bas est moins inquiétant.Comment on la calcule : ancienneté, republications, postes ouverts vs taille de l'équipe, rapidité de clôture, et si le salaire est indiqué.À noter : une estimation à partir de données publiques, pas un jugement sur l'entreprise. De vraies offres peuvent avoir un score élevé, alors prenez-le comme un indice, pas comme un fait.

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Talkspace

Site WebLinkedInTous les Emplois

201 - 500 employés

Fondée en 2011

💼 Conseil

🏥 Santé

🛍️ eCommerce

Consulting • Healthcare • eCommerce

Talkspace est une plateforme de thérapie en ligne qui propose des soins de santé mentale accessibles grâce à des thérapeutes licenciés et des prestataires psychiatriques. Les utilisateurs peuvent participer à des séances de thérapie par texte, audio et vidéo, ainsi que recevoir une gestion de la médication si nécessaire. Talkspace vise à rendre la thérapie pratique et abordable en collaborant avec les principaux assureurs et en offrant diverses options de traitement pour les individus, les couples et les adolescents confrontés à une gamme de problèmes de santé mentale.

Description

• Lead and manage a small group of Credentialing Interns, Associates, and Specialists, overseeing job assignments, performance reviews, and professional development while ensuring alignment with organizational goals. • Approve timesheets, provide mentorship, and offer strategic support to optimize team performance and ensure operational success. • Streamline operational processes related to credentialing. • Prepare and present comprehensive credentialing packets for the Credentialing Committee, including flagged file reviews, logistics coordination, and credentialing KPI reporting. • Liaise with the Credentialing Verification Organization and Credentialing Supervisor to ensure timely completion, downloading, and uploading of files and accurate system updates. • Collaborate with credentialing stakeholders and the CVO to improve outreach, resolve inconsistencies, and facilitate weekly meetings. • Initiate and manage timely provider re-credentialing, including quality and complaint data review and provider documentation. • Identify non-engaging, zero-caseload providers and process administrative terminations when unresponsive. • Coordinate completion and scheduling of clinician re-credentialing cycles with the CVO. • Support delegated credentialing relationships with Enterprise clients and Account Management. • Provide regular network update reports and monthly roster reports to Enterprise clients. • Submit and track pre-delegation enrollment packets and outcomes. • Conduct regular CVO audits and quarterly internal Credentialing Program audits. • Provide data for Enterprise client audits. • Oversee review of credentialed licenses and support ongoing monitoring documentation and reporting. • Continuously review and refine credentialing workflows and implement best practices. • Perform other related duties as assigned.

🎯 Exigences

• Bachelor’s Degree required (Master’s Degree preferred) or 7+ years of professional experience in credentialing or a related field. • 4+ years of professional experience in a credentialing, compliance, or healthcare operations role, with proven experience in team leadership and process management. • Strong background in managing credentialing operations, including experience working with Credentialing Verification Organizations (CVOs) and handling delegated credentialing agreements. • Familiar with NCQA standards and guidelines as well as policy and contract review to ensure compliance with said standards. • Demonstrated ability to manage cross-functional teams, lead projects, and streamline workflows to optimize efficiency. • Excellent communication, organizational, and problem-solving skills, with a strong focus on collaboration with both internal and external stakeholders. • Experience in conducting audits, maintaining compliance with regulatory standards, and implementing process improvements. • Familiarity with credentialing software and systems, as well as proficiency in reporting on credentialing metrics. • Proficient with Mac devices, Excel, Word, Google Suite (sheets, docs).

🏖️ Avantages

• Comprehensive Medical, Dental and Vision plans • Pre-tax benefits: HSA/ FSA • 401k Retirement Savings Program with matching up to 4% • Voluntary benefits including disability, basic life or pet insurance, etc. • Monthly Wellness Stipend to promote mental and physical self-care • Flexible PTO and Remote First Environment • Regular team events, including Wellness Workshops and Team Building Events • Free access to Talkspace products for you and one household member, as well as access to a friends and family discount!