Certified Woman & Minority Owned

Provider Credentialing


Reference Number: SMRIAI13

Provider Credentialing
experience  Not Disclosed
location  Woonsocket, RI (100% Remote)
duration  6.0 Months
salary  Not Disclosed
jobtype  Not Disclosed
Industry  Healthcare
duration  $-4/hour - $1/hour
Job Description

Remote

Description:

Position Summary
The client is seeking an analyst experienced in health care or health plan compliance monitoring and auditing to join our Credentialing and Payer Delegation team. This position supports the credentialing compliance monitoring program activities, auditing, data collection, trend analysis and meeting timeliness for delegated payer deliverables.

Assists in the preparation of deliverables for payer and internal audit requests
Assist with credentialing tasks as needed
Building and maintaining effective, positive internal and external customer relationships
Conducting ongoing monitoring to evaluate levels of regulatory credentialing and delegated payer compliance with contractual and requirements
Exhibiting client at Work Behaviors
Participating in team initiatives and projects and meeting deadlines and quality expectations
Participates in the development and ongoing implementation of quality improvement activities. Improve quality products and services, by using measurements and analysis to process, evaluate and make recommendations to meet QM compliance objectives
Performing credentialing business process functions as needed, performing scheduled and random credentialing file audits
Reviewing risk assessments while participating in ongoing monitoring and annual program evaluation and identification of areas where there can be process improvement

Experience:
-3+ years of related health care or health plan experience in credentialing compliance, auditing, and quality assurance
-Proficient in Microsoft Office Applications; Excel, Outlook, Word, and Teams
-The ability to create spreadsheets, analyze data and identify trends.
-Strong attention to detail and the ability to multi-task in a fast-paced environment
-MDStaff experience is preferred

Education:
Bachelor’s Degree

Experience
2 years’ experience with NCQA compliance
1 year MD-Staff experience preferred.
1 year of credentialing software experience required. Application processing, NPI, NPDB and license verifications
Independent time management in a work from home environment





Notes:
Normal work hours Mon-Fri 8:30-5. Training hours Mon-Fri 9:30a-4p EST for approximately two

Fully remote (never coming onsite)
Safety Sensitive = DT required


VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status

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