Company Statement
EmblemHealth is one of the nation’s largest not for profit health insurers, serving members across New York’s diverse communities with a full range of commercial and government-sponsored health plans for employers, individuals, and families. With a commitment to value-based care, EmblemHealth partners with top hospitals and doctors, including its own AdvantageCare Physicians, to deliver quality, affordable, convenient care. At over a dozen EmblemHealth Neighborhood Care locations, members and non-members alike have access to community-based health and wellness guidance and resources. For more information, visit emblemhealth.com.
Director, Credentialing - Remote
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 3 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 receive a job offer from EmblemHealth, the email will be from “HRTalentAcquisition” with the subject: “Offer of Employment for (job title) – Please respond online.” We will never ask you to join a Google Hangout, buy your own equipment, or pay to apply. We also do not use third-party email services like Yahoo or Gmail.
Pay Disclosure
At EmblemHealth, we prioritize transparency in our compensation practices. We provide a good faith estimate of the salary range for potential hires, which is based on key factors such as role responsibilities, candidate experience, education and training, internal equity, and market conditions. Please be aware that this estimate doesn’t account for geographic differences related to your work location. Typically, new hires may not start at the top of this range, as compensation is tailored to each individual's circumstances. For union positions, salaries will be determined according to the collective bargaining agreement. Join us at EmblemHealth, where your contributions are valued and supported by fair compensation.
EEOC Statement
We value the diverse backgrounds, perspectives, and experiences of our workforce. As an equal opportunity employer, we consider all qualified applicants for employment regardless of race, color, religion, sex, sexual orientation, gender identity, pregnancy, marital status, national origin, disability, veteran status, or any other protected characteristic protected by law.
Sponsorship Statement
EmblemHealth may provide work visa sponsorship depending on factors such as business unit requirements, position nature, costs, and applicable laws and regulations.