Location
Overland Park, KS, United States
Posted on
Mar 02, 2022
Profile
Job Information
Humana
Supervisor, Credentialing
in
Overland Park
Kansas
Description
Responsibilities
The Supervisor, Credentialing Operations
is responsible for supervising activities associated with certification and recertification of providers in the TRICARE East Region. This position supervises staff in processing provider certification applications and reapplications including collection of applications, application follow-up, primary source verification and collection of qualifications, and quality review. In this position you will be responsible for certification systems creation and maintenance. You will monitor ongoing certification activities in accordance with TRICARE regulations. Coordinate, create, and maintain certification reporting requirements according to TRICARE CDRLs and business practices. Utilize information systems interactive reports to identify and analyze trends on application statuses and processes and associate productivity.
KEY ACCOUNTABILITIES
25% Supervises and evaluates certification staff providing feedback regarding role performance and promoting individual accountability
25% Evaluates and monitors workload distribution, systems, processes, production, and quality to ensure adherence to TRICARE regulations
20% Coordination with other departments for process impacts, conflict resolution, and efficient and effective processes. Build teamwork amongst associates
20% Assists with reviewing, updating and maintaining Certification policies & procedures
10% Refers to manager for escalated issues
This position description in no way states or implies that the key accountabilities above are the only ones being performed by the individual(s) with this role description. The individual(s) may be called upon and required to follow other instructions or perform other duties and tasks requested by his or her supervisor, consistent with the purpose of the position, department and/or company objectives
Required Qualifications
TRICARE certification experience and/or 2 plus years of experience in provider credentialing and/or certification
3 plus years of managed care environment experience
2 plus years of leadership/management experience
Bachelor's degree in Business, Healthcare Administration or related field
Excellent written and verbal communication skills
Microsoft Office (Word, Excel, Outlook) Proficient to include MS Access
Experience problem solving and consultation with complex environments
Our Department of Defense Contract requires U.S. citizenship for this position
Successfully receive interim approval for government security clearance (eQIP - Electronic Questionnaire for Investigation Processing)
For this job, associates are required to be fully COVID vaccinated, including booster or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve
If progressed to offer, you will be required to: Provide proof of full vaccination, including booster or commit to testing protocols OR
Provide proof of applicable exemption including any required supporting documentation
Medical, religious, state and remote-only work exemptions are available
Work at Home/Remote Requirements
Must ensure designated work area is free from distractions during work hours and virtual meetings
Must provide a high-speed DSL or cable modem for a workspace (Satellite and Hotspots are prohibited). At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended to support Humana applications.
Preferred Qualifications
Master's degree in Healthcare Administration, MBA or related field
Experience in TRICARE or other federally regulated healthcare programs
Strong technical skills with Access or SQL
Additional Information
As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.
If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.
If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
Scheduled Weekly Hours
40
Company info
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