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.
To protect the health and safety of our workforce, members, patients, and the communities we serve, the EmblemHealth family of companies require all new employees to be fully vaccinated for COVID-19. Exemption/reasonable accommodations may be granted because of 1) a qualifying medical condition or disability that makes getting the vaccine unsafe for the individual, or 2) objection on the basis of sincerely held religious beliefs and/or practices.
Sr. Provider Network Compliance Specialist
Qualifications:
- Bachelor’s Degree
- 4 – 6 years of relevant work experience, preferably with a healthcare provider (R)
- Additional years of relevant experience may be considered in lieu of educational requirements (R)
- Knowledge of managed care/regulatory requirements (R)
- Ability to: effectively multitask; manage a high volume of work; ensure regulatory deadlines are met (R)
- Ability to review regulatory inquiries, interpret requests and draft appropriate responses (R)
- Excellent communications skills (verbal, written, presentation); and the ability to effectively facilitate/control meetings (R)
- Proficient in Word, Excel, and Outlook; knowledge of Adobe Acrobat, Nuance Converter, Tagging (508 Compliance) (R)
- Experience with managing/leading projects (R)
- Must be able to: work independently and show initiative; and work collaboratively with others and build positive relationships internally and externally (R)
- Attention to detail in order to identify discrepancies when reviewing large documents and spreadsheets (R)
- Ability to use good judgment in decision making and maintain professionalism at all times (R)
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, 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.