at Health Care Service Corporation in Lombard, Illinois, United States
Job Description
At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career.
Come join us and be part of a purpose driven company who is invested in your future!
Job Summary
Job Purpose:
Under supervision, this role is responsible for coordinating correspondence to network providers, updates to provider contract and credentialing documents, as well as ensuring brand and corporate standards, as well as regulatory requirements are met for all provider network related correspondence. The role is responsible for implementation and maintenance of the templates utilized for correspondence required based on operational activity and driven by requirements defined by federal/state regulation, NCQA and URAC.
Required Job Qualifications:
* Bachelor's degree and 2 years of experience in accreditation programs (i.e., NCQA, URAC and CMS programs) or 6 years' experience in accreditation program standards and compliance.
* Proficiency in accreditation program standards including NCQA, URAC and CMS
* Ability to analyze and conduct review and socialize with the appropriate stakeholders (Leadership, Compliance, Legal, etc.) which will result in changes to policy and provider contracting materials.
* Exceptional communication skills and the ability to communicate appropriately at all levels of the organization. This to also include the ability to communicate appropriately with external customers, including clients and/or regulatory agencies.
* Knowledge of state and federal requirements for contracting and credentialing.
* Attention to detail and ability to track information to defined quality standards
* Ability to update and edit correspondence, ensuring accuracy, proper grammar, and consistency of style, conciseness, and proper format.
* Knowledge of documents and their contents used in provider contracting, including applications, agreements, fee schedules, and credentialing.
* Experience balancing multiple priorities while meeting commitments for quality and delivery at agreed upon schedules.
* Exhibit problem-solving, communication, and decision-making skills.
* Excellent independent problem-solving skills
* Self-motivated and has the ability to work with little supervision and make independent decisions.
* Demonstrated track record of attention to detail.
* Clear and concise verbal and written communication skills.
* Proficient in Microsoft Office products, email and Internet.
* Ability to work well in a team environment.
Preferred Job Qualifications:
* Analytical skills
* Knowledge of Dental industry
#LI-HYBRID
We encourage people of all backgrounds and experiences to apply.
Even if you don't think you are a perfect fit, apply anyway - you might have qualifications we haven't even thought of yet.
Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!
HCSC Employment Statement:
HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
BCBSTX complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
