Senior Credentialing Representative
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
The Senior Credentialing Representative supports provider credentialing across multiple markets by managing end-to-end data entry, provider file preparation and system loading within MD Staff and related credentialing platforms. The position conducts audits, identifying process improvements and independently resolving complex issues. The role plays a critical part in ensuring accurate, compliant credentialing operations.
Get ready for some significant challenge. This is a performance driven, fast paced environment where accuracy is key. You'll be helping us confirm to very exacting standards such as NCQA, CMS and state credentialing requirements.
Schedule: Monday to Friday, 8 AM- 5 PM, flexible time zone
Location: Remote - Nationwide
You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Help process provider applications and re-applications including initial mailing, review and loading into the database tracking system
Conduct audits and provide feedback to reduce errors and improve processes and performance
Complete delegation rosters accurately with great attention to detail and discernment to ask questions as needed
Demonstrate great depth of knowledge/skills in own function and act as a technical resource to others
Solve complex problems on own; proactively identify new solutions to problems
Demonstrate great depth of knowledge/skills in own function and act as a technical resource to others
Solve complex problems on own; proactively identify new solutions to problems
Act as a facilitator to resolve conflicts on team
Perform as key team member on project teams spanning more than own function
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:
High School Diploma/GED (or higher)
4+ years of healthcare provider credentialing experience
2+ years of experience working with compliance workflows and processes, including NCQA policies and practices
Intermediate level of proficiency with MS Excel and Word
Preferred Qualifications:
MD Staff software experience
Behavioral health enrollment experience
Prior delegation experience
Multistate enrollment experience
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you’ll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.38 to $36.44 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
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.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
#RPO #GREEN
Apply To This Job
The Senior Credentialing Representative supports provider credentialing across multiple markets by managing end-to-end data entry, provider file preparation and system loading within MD Staff and related credentialing platforms. The position conducts audits, identifying process improvements and independently resolving complex issues. The role plays a critical part in ensuring accurate, compliant credentialing operations.
Get ready for some significant challenge. This is a performance driven, fast paced environment where accuracy is key. You'll be helping us confirm to very exacting standards such as NCQA, CMS and state credentialing requirements.
Schedule: Monday to Friday, 8 AM- 5 PM, flexible time zone
Location: Remote - Nationwide
You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Help process provider applications and re-applications including initial mailing, review and loading into the database tracking system
Conduct audits and provide feedback to reduce errors and improve processes and performance
Complete delegation rosters accurately with great attention to detail and discernment to ask questions as needed
Demonstrate great depth of knowledge/skills in own function and act as a technical resource to others
Solve complex problems on own; proactively identify new solutions to problems
Demonstrate great depth of knowledge/skills in own function and act as a technical resource to others
Solve complex problems on own; proactively identify new solutions to problems
Act as a facilitator to resolve conflicts on team
Perform as key team member on project teams spanning more than own function
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:
High School Diploma/GED (or higher)
4+ years of healthcare provider credentialing experience
2+ years of experience working with compliance workflows and processes, including NCQA policies and practices
Intermediate level of proficiency with MS Excel and Word
Preferred Qualifications:
MD Staff software experience
Behavioral health enrollment experience
Prior delegation experience
Multistate enrollment experience
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you’ll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.38 to $36.44 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
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.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
#RPO #GREEN
Apply To This Job