Work Location - Remote, Work from Home
The AVP of Provider Credentialing is a Corporate Network leadership position responsible for leading and managing enterprise-wide credentialing and provider enrollment.
- Oversees and leads enterprise-level credentialing function and provider enrollment.
- Develops and refines provider adoption strategies related to initiatives impacting provider networks, and assists with coordination health plan provider services staff training.
- Acts as enterprise process leader for provider credentialing and business owner for provider enrollment and credentialing system/platform.
- Responsible for continuous process improvement in provider enrollment and credentialing processes including standardized "Tool Kits", training program(s), and deployment plan(s).
- Represents Network Strategy & Services in partnership with Health Care Services, Operations, Quality, and Health Plan business partners to ensure incorporation of Network provider engagement/credentialing strategics to achieve positive operational, financial outcomes and maintain compliance with applicable regulatory requirements.
- Monitors key performance indicators and metrics to assess provider enrollment & credentialing effectiveness, efficiency and compliance.
- Oversees the initial credentialing and re-credentialing of all non-delegated providers.
- Oversees yearly maintenance of all MHI policy and procedures related to credentialing and provider Enrollment.
- Leads one or more provider credentialing directors and their team(s).
- 10 years experience in Healthcare with specific experience in Network Management, Operations or Provider Services.
- Experience leading and managing employees, preferably in a production-related management role.
- Demonstrated adaptability and flexibility to changes and response to new ideas and approaches.
- Superior problem-solving skills including root cause analysis and prompt resolution.
- Excellent interpersonal and communication skills (verbal and written).
- Must have strong PC skills (Word, Excel, Outlook, PowerPoint)
- Must have strong presentation and leadership skills.
REQU I RED ED U C A TI O N :
Bachelor's Degree in a related field (Healthcare Management, Business Administration, etc.) or equivalent combination of years of experience in lieu of Degree.
PR E FE R RED ED U C A TI O N :
Master's Degree in a related field (Healthcare Management, Business Administration, etc.)
Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.