Company Statement
For the last 80 years, EmblemHealth has been taking care of New York’s heart and soul, its people. Today, health care is more complex than ever. That’s why we’re at the forefront of change. We work alongside our customers to offer access to high-quality, affordable care, help navigate the health care experience, and make good health achievable; because everyone deserves to be taken care of. We deliver on our mission every day by living our values with our colleagues, members, clients and partners. It begins with caring and respecting all those we work with. We believe a culture of diversity and inclusion is vital to serve our unique and diverse customers. We seek for continues improvement and innovation and believe being agile and nimble is our advantage. We bring a strong sense of partnership to every relationship – internally and externally. The EmblemHealth family of companies offers competitive health, welfare, and retirement benefits as well as incentive pay plans and more.
Director, Credentialing
Requirements:
- BS or BA degree required
- Certified Provider Credentialing Specialist (CPCS) and Certified Professional in Medical Staff Service Management (CPMSM) is preferred
- 10+ years of relevant professional experience in credentialing and 7 years in a leadership capacity required
- 5+ years of experience in Quality Mgmt. & Improvement, Change Management, and Customer Experience preferred
- Track record of successfully managing large, high impact projects preferred
- Ability to lead, develop, mentor, and manage staff to achieve departmental and organization goals and objectives required
- Knowledge of delegated credentialing and verification, and related accreditation and certification, requirements required
- Knowledge of medical credentialing procedures and standards required
- Extensive experience with and knowledge of CAQH and credentialing processes required
- Energy, drive and passion for End-to-End excellence and customer experience improvement required
- Excellent collaboration skills and the ability to influence management decisions required
- Strong problem solving and analytical skills that can be applied across all types of business problems required
- Strong communication skills (verbal, written, presentation, interpersonal, facilitation) required
- Solid coaching and mentoring skills to continuously develop staff core competencies at vendors required
- Demonstrated Customer Experience focus and 1 year of process improvement experience required
- Ability to work with physicians in a collaborative manner required
- Ability to create, implement, document and audit policies and procedures required
- Ability to manage direct/indirect/remote employees to ensure internal controls are followed required
- Ability to effectively prioritize and execute tasks in a high-pressure environment required
Security Disclosure
If you are offered a job from one of the EmblemHealth family of companies that includes ConnectiCare, AdvantageCare Physicians, and WellSpark, the offer confirmation email will come from “HRTalentAcquisition” with the subject line: “Offer of Employment for (job title)” – Please respond online”.
We never ask you to join a Google Hangout, request you to purchase your own equipment or pay to apply. We do not send email from a third-party email service such as Yahoo or Gmail.
Pay Disclosure
A good faith estimate of the compensation range for individuals hired to work for the EmblemHealth Family of Companies is provided. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, internal peer equity, and market and business considerations. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. It is not typical for an individual to be hired at or near the top of the range, as compensation decisions depend on each case’s facts and circumstances. Union roles covered by a collective bargaining agreement will compensate in accordance with the union contract.
EEOC Statement
We are committed to leveraging the diverse backgrounds, perspectives, and experiences of our workforce to create opportunities for our people and our business. We are an equal opportunity/affirmative action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy or related condition, marital status, national origin, disability, protected veteran status or any other characteristic protected by law.
Sponsorship Statement
Depending on factors such as business unit requirements, the nature of the position, cost and applicable laws and regulations, EmblemHealth may provide work visa sponsorship for certain positions.