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   Current UPMC employees must apply in HR Direct

Credentialing Supervisor, HPL

  • Job ID: 973855603
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: UPMC Health Plan
  • Department: Quality Improvement
  • Location: 600 Grant St, Pittsburgh PA 15219
  • Union Position: No
  • Salary Range: $21.64 to $37.36 / hour

Description


The Supervisor is accountable for managing the day to day operations including project management, process improvement and problem resolution for the Credentialing areas. Interacts with Health Plan staff, PHO Executive Directors, physicians and others involved in the credentialing process.

Responsibilities:
  • Attend and participate in Quality Improvement Committee Meetings as needed.
  • Provide supervision and direction to credentialing staff in order to meet departmental objectives.
  • Develop, monitor and continuously improve credentialing processes to ensure data integrity and consistency with strategic corporate goals and objectives.
  • Participate on cross-functional project teams.
  • Maintain staff performance by evaluating, coaching and disciplining employees when necessary.
  • Ensure credentialing process is in compliance with the Department of Health, National Committee for Quality Assurance standards, Department of Public Welfare and Center for Medicare/Medicaid Services.
  • Establish work plans to meet goals and objectives of the department.
  • Contribute to the organization's effectiveness by identifying issues, providing information, recommending courses of action and implementing appropriate action plans.
  • Function as the liaison to the Credentialing Chairperson to coordinate the activities of the Credentialing Committee.

Qualifications

  • Bachelors' Degree preferable in healthcare.
  • Master's degree preferred.  
  • Previous applicable experience may be substituted for the educational requirements.
  • Understanding of health insurance industry, with a focus on managed care delivery systems.  
  • Six to eight years related experience in working with physicians and hospital providers required
  • Experience with NCQA compliant credentialing - required
  • Supervisory skills and project management experience - required
  • Excellent written and verbal communication skills, as well as the ability to handle multiple priorities/projects - Required
  • PC proficiency and familiarity with all standard software packages - Required

Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran

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No matter where we work or what we do, we’re driven by common values that guide our work and keep us accountable to one another. UPMC’s values of Quality & Safety, Dignity & Respect, Caring & Listening, Responsibility & Integrity, Excellence & Innovation play a vital role in creating a cohesive, positive, experience for our employees, patients, health plan members, and community. Ready to join us? Apply today.

   Current UPMC employees must apply in HR Direct

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