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Role Description

The Supervisor, Dental Provider Data Maintenance & Credentialing supervises the daily tasks of the Provider Data Maintenance & Credentialing Specialist I. This role works with outside vendors including but not limited to CVO, Dental Directors, Print and Mail Services.

• Monitors workflow within the team and with outside vendors such as the CVO and identifies opportunities for process improvements.
• Coaches and provides assistance and feedback to staff as needed.
• Researches, plans, and prepares departmental reports to ensure accuracy and efficiency of the team's data entry and adherence to NCQA protocols for credentialing and re-credentialing.
• Works directly with internal and external auditors and follows up on any recommended actions.
• Works directly with Dental Director and Credentialing Committee attendees to ensure all files are reviewed, signed off on and any follow-up action completed.
• Facilitates all mailings associated with re-credentialing to ensure that NCQA guidelines relative to timeliness are being met.
• May perform other duties, including the daily functions of the credentialing team as assigned.
• Monitors and recommends adjustments to workflow processes and staff assignments.
• Prepares performance reviews, and administrative action documentation, and reviews with staff as necessary.
• Coordinates audit reviews as necessary and follows up on any action items.
• Manages reports to monitor efficiency and quality review.
• Prepares the monthly agenda for Credentialing Committee meeting.
• Makes all preparations for the Credentialing Committee Meeting and attends and creates meeting minutes.
• Drafts letters for all tabled cases and prepares check requests for the attendees' stipends.

Qualifications

• Knowledge of general credentialing processes.
• Knowledge of CVOs and NCQA Credentialing Guidelines.
• Advanced MS Office skills, particularly Excel.
• Excellent verbal and written communication skills including the ability to compose professional correspondence.
• Demonstrated leadership skills and the ability to assist and guide others.
• Ability to supervise staff using appropriate tools and techniques.
• Ability to maintain attention to detail and a low error rate.
• Ability to prioritize tasks and work within time constraints.

Requirements

• Bachelor’s Degree or related experience.
• 3 to 5 years’ provider data maintenance & credentialing experience.
• Credentialing Delegation Oversight experience.
• Minimum 1 year of management experience.
• Or, equivalent military experience.

Preferred Education and Experience

• 3 years as a Credentialing Specialist II.
• Certified Provider Credentialing Specialist (CPCS®).

Benefits

• A culture that values employees and celebrates, empowers, and inspires a diverse workforce.
• Outstanding and affordable benefits package.
• PTO provided at date of hire.
• 11 paid holidays.
• 401(k) with up to 6% match; fully vested from day 1.
• Remote opportunities with company-provided equipment.
• Team-oriented, collaborative group of peers.
• Career advancement opportunities.
• Tuition Reimbursement.
• Employee Assistance Program.
• Inclusion Council and Employee Resource Groups.
• Recharge Days and Volunteer Time Off.