Credentialing Specialist - Remote Job in Plymouth | Yulys
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Job Title: Credentialing Specialist - Remote

Company Name: Optum
Salary: USD 27.00
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USD 53.00 Hourly
Job Industry: Health, Wellness and Fitness
Job Type: Full time
WorkPlace Type: On-Site
Location: Plymouth, Michigan, United States
Required Candidates: 1 Candidates
Job Description:

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.

 

This role is responsible for the successful initiation, execution, and monitoring of strategic acquisition integrations within Credentialing and Enrollment. This role will be responsible for working with cross-functional departments on the planning, execution and post-implementation monitoring of newly acquired entities. Responsibilities also include resolution of issues and the mitigation of risks where they pose a significant threat to success, always with a focus on delivering value to the business. Additional responsibilities include supporting large-scale projects and leading internal projects within the Credentialing and Enrollment Team. This position handles and manages confidential material relating to corporate decisions, structure and significance.

 

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

 

Primary Responsibilities:

  • Ensures integration timelines are met in accordance with the approved project plan
  • Directs and provides guidance to new providers and staff through implementation, and execution of orientation, and training to new acquisitions
  • Provides information to departments as needed and serves as the departmental liaison for all providers and staff
  • Sets direction, resolves problems, and provides guidance to the Credentialing and Enrollment Team in coordination with the managers/supervisors
  • Serve as the primary point of contact for Credentialing and Enrollment for acquired physicians and staff for the first 100+ days post-close
  • Develop and maintain clear and concise project plans or project schedules tracking upcoming, existing and post-steady state (100+ days). This work product reflects all of the credentialing and enrollment work (regardless of the status of the acquisition - pre-close, close period, post-close)
  • Document, facilitate and oversee handoff of steady state activities once the majority of key integration activities are complete
  • Completes deliverables, including due diligence reviews for the Credentialing and Enrollment workstream
  • Provides regular feedback regarding the needs of local management and operational teams for acquisition transition activities
  • Identifies process standardization opportunities, leads the implementation of adoption of best practices and process improvement efforts in partnership with the Diligence and Integration team
  • Ability to anticipate areas of difficulty/potential unknown risks, contribute towards creative solutions and moves to action quickly
  • Acts as a subject matter resource and contributes to large-scale, cross-functional projects

 


You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

  • Undergraduate degree (3+ years of comparable work experience beyond the required years of experience may be substituted in lieu of an undergraduate degree)
  • 3+ years of experience managing/leading others
  • Demonstrated experience with healthcare regulatory and compliance standards
  • Knowledge of organization policies and procedures and ability to read, interpret, and apply
  • Familiar with healthcare concepts and practices as it relates to providers and group entities
  • Demonstrated ability to communicate effectively verbally and in writing, with all levels of the organization
  • Proven solid interpersonal skills with ability to interface effectively both externally and internally with a wide range of people including physicians, office staff and other health plan staff

 

Preferred Qualifications:

  • Project experience
  • Experience with Mergers & Acquisitions and business integration
  • Experience working with credentialing systems (i.e., Credential Stream, MD Staff)
  • Knowledge of NCQA guidelines and standard practices

 


California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The hourly range for California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island or Washington residents is $27.07 to $53.08 per hour. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

 

  • All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

 

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

 

 

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

 

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

 

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