Manager, Provider Enrollment and Credentialing (DentaQuest) - Oklahoma
- Oklahoma
- Permanent
- Full-time
The Manager, Provider Enrollment & Credentialing is responsible for managing and monitoring staff and systems that guide the accurate and timely tracking and monitoring of provider-related enrollment and credentialing activities.How you will contribute:
- Oversee enrollment and credentialing of Providers following requirements (NCQA, CMS, DDPA, etc.).
- Collaboratively work with Quality Assurance to ensure an effective audit process, which will result in the ability to develop staff training content.
- Ensure the company’s processes meet client expectations, Federal and state regulations.
- Assist with credentialing audits as needed.
- Ensure all Applications are tracked.
- Manage staff members to ensure high-performing teams
- Complete necessary reporting to ensure staff members are completing work within the established TAT and accuracy.
- Complete necessary reporting to ensure staff members are meeting productivity requirements.
- Production of monthly staff member scorecards.
- Train and motivate team members.
- Conduct monthly one-on-one sessions for coaching and mentoring.
- Write and deliver corrective action plans when appropriate.
- Create a culture that embraces the company’s vision, mission, and goals.
- Continuously evaluate resources to ensure they are appropriately allocated to meet all Provider Operations deadlines and required outcomes.
- Implement, monitor, and maintain process changes resulting from corrective action plans.
- Identify issues and inefficiencies to make recommendations for process improvements.
- Resolve complaints and issues with providers.
- Engage and maintain relationships with internal customers to ensure provider satisfaction.
- Serve as a SME to advise our internal and external customers to proactively meet customer needs.
- Coordinate and implement appropriate performance management strategies for team members to include:
- Actively participates in the hiring process, including interviewing candidates.
- Actively participate in the preparation of performance and wage evaluations per company policy.
- Monitor and manage attendance and company-approved time off for team members.
- Update the management team timely manner on any concerns or issues.
- Other duties as assigned.
- Bachelor’s degree in Health Care or relevant field, preferred.
- 3+ years of supervisory experience required.
- Knowledge of NCQA, URAC & CMS, and other quality requirements preferred.
- Excellent PC skills with proficiency in MS Office products.
- Excellent oral and written communication skills.
- Strong customer service and reasoning skills.
- Strong Project management and process improvement skills.
- Ability to manage staff and work well with others.
- Ability to prioritize and organize multiple tasks and remain organized with multiple interruptions.
- Ability to meet multiple deadlines.
- Ability to work more than 40 hours per week, as needed or required to meet business objectives.