Director, Provider Data Management
Altais
full-time
Posted on:
Location Type: Hybrid
Location: California • United States
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Salary
💰 $141,900 - $170,280 per year
Job Level
About the role
- Provide leadership / coaching to the credentialing team staff, ensuring function initiatives and deliverables are complete and accurate in a timely manner
- Responsible for the oversight of processing credentialing applications accurately and promptly in accordance with Credentialing policies and procedures and in full compliance with all regulations with a continued focus on delivery of a high-quality product with the greatest level of efficiency
- Own end to end delegated credentialing process, including management of the Provider Directory and any related Provider Engagement Portal, or equivalent
- Direct audit preparation of materials and files necessary to comply with external audits by payors and/or governmental agencies
- Manages relationships with health plan delegation oversight committee members
Requirements
- Bachelor’s degree or equivalent to 4-year university degree, preferably in healthcare related field of study
- Minimum of 10 years of credentialing, or regulatory affairs experience, preferably in a managed care or insurance environment
- 6 years of leadership experience
- Credentialing software experience
- Experience leading Health Plan audit activities
- Experience with and knowledge of CAQH and credentialing processes
- Knowledge of delegated credentialing and verification
- Knowledge of related accreditation and certification requirements
- Knowledge of medical credentialing procedures and standards
- Excellent communication skills, both written and verbal, as well as strong organizational and administrative abilities
- Advanced Excel knowledge
Benefits
- Excellent medical, vision, and dental coverage
- 401k savings plan with a company match
- Flexible time off and 9 Paid Holidays
- Eligible to participate in our annual bonus program
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
credentialingregulatory affairsaudit preparationCAQHdelegated credentialingcredentialing processesmedical credentialing proceduresadvanced Excel
Soft Skills
leadershipcoachingcommunicationorganizational skillsadministrative abilities