Credentialing Supervisor

Our Promise

Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.

As the Supervisor of Credentialing, you'll work to uphold rigorous standards, ensuring adherence to State and Federal regulations, National Committee for Quality Assurance (NCQA) standards, and other industry benchmarks. You will have direct responsibility for leading a team of Credentialing Specialists who carry out the day to day work to enroll providers in the Avesis provider networks. You'll also have the opportunity to shape the future of provider data standards, process improvements, and team development, all while maintaining a culture of quality and compliance. As the Supervisor, you will be a guide to your team on credentialing processes and maintaining best-in-class practices to support Avesis' continued growth and success. If you have a passion for healthcare compliance, a proven track record of leadership, and a strategic mindset, we want you to join our fully remote, dynamic team at Avesis.

Competencies:

Functional:

• Lead a first-class, metrics-driven credentialing operation maintaining compliant operations while achieving best-in-class turnaround times.
• Provide leadership, mentoring, training, and coaching to all Credentialing Specialists.
• Effectively work with internal department and clinical support to identify best practices and opportunities to improve quality performance.
• Meet with direct reports on a routine basis for one on ones, provide performance feedback, and coach/counsel employees as needed. Document performance when needed. Complete annual performance appraisals and recommend salary adjustments.
• Keep pace with regulatory changes and work internally to modify systems and processes to mitigate any negative impact.
• Manage and maintain positive engagement with CVO and other external credentialing vendors
• Maintain a comprehensive understanding of healthcare credentialing requirements.
• Support and Implement department goals and continuous process improvement initiatives.
• Provide support to the Credentialing Team to ensure adequate performance.

Core:

• Working knowledge of NCQA standards and payer credentialing standards.
• Working knowledge of best practices for provider data management and maintenance.
• Knowledge of PSV (primary source verifications), CAQH, OIG (Office of Inspector General) & NPDB (National Practitioner Data Bank).
• Working knowledge of credentialing databases to manage, track, and verify provider data.
• Strong computer, data entry and analysis skills.

Behavioral:

• Collegiality: building strong relationships on company-wide, approachable, and helpful, ability to mentor and support team growth.
• Initiative: readiness to lead or take action to achieve goals.
• Communicative: ability to relay issues, concepts, and ideas to others easily orally and in writing.
• Member-focused: going above and beyond to make our members feel seen, valued, and appreciated.
• Detail-oriented and thorough: managing and completing details of assignments without too much oversight.
• Flexible and responsive: managing new demands, changes, and situations.
• Critical Thinking: effectively troubleshoot complex issues, problem solve and multi-task.
• Integrity & responsibility: acting with a clear sense of ownership for actions, decisions and to keep information confidential when required.
• Collaborative: ability to represent your own interests while being fair to those representing other or competing ideas in search of a workable solution for all parties.

Minimum Qualifications:

• Bachelor's degree or equivalent education and experience
• CPCS Certification required, may be obtained within 6 months of accepting position
• 3+ years of credentialing experience in a managed care setting
• Intermediate skill level in Microsoft Excel
• 3+ years of experience managing and maintaining provider network databases.
• As this role is a remote role, you are required to maintain internet service that allows you to complete your essential job duties without issue. Rates of 50 Mbps download and 10 Mbps upload while hardwired and not on a VPN are sufficient.

Preferred Qualifications:

• Knowledge of vision or dental industry.
• 1-2 years leadership and performance management experience

At Avsis, we strive to design equitable, and competitive compensation programs. Base pay within the range is ultimately determined by a candidate's skills, expertise, or experience. In the United States, we have three geographic pay zones. For this role, our current pay ranges for new hires in each zone are:

This role may also be eligible for benefits, bonuses, and commission.

Please visit Avesis Pay Zones for more information on which locations are included in each of our geographic pay zones. However, please confirm the zone for your specific location with your recruiter.

We Offer

• Meaningful and challenging work opportunities to accelerate innovation in a secure and compliant way.
• Competitive compensation package.
• Excellent medical, dental, supplemental health, life and vision coverage for you and your dependents with no wait period.
• Life and disability insurance.
• A great 401(k) with company match.
• Tuition assistance, paid parental leave and backup family care.
• Dynamic, modern work environments that promote collaboration and creativity to develop and empower talent.
• Flexible time off, dress code, and work location policies to balance your work and life in the ways that suit you best.
• Employee Resource Groups that advocate for inclusion and diversity in all that we do.
• Social responsibility in all aspects of our work. We volunteer within our local communities, create educational alliances with colleges, drive a variety of initiatives in sustainability.

How To Stay Safe

Avsis is aware of fraudulent activity by individuals falsely representing themselves as Avsis recruiters. In some instances, these individuals may even contact applicants with a job offer letter, ask applicants to make purchases (i.e., a laptop or gift cards) from a designated vendor, have applicants fill out W-2 forms, or ask that applicants ship or send packages of goods to the company.

Avsis would never make such requests to applicants at any time throughout our job application process. We also would never ask applicants for personal information, such as passport numbers, bank account numbers, or social security numbers, during our process. Our recruitment process takes place by phone and via trusted business communication platform (i.e., Zoom, Webex, Microsoft Teams, etc.). Any emails from Avsis recruiters will come from a verified email address ending in @ Avsiscom.

We urge all applicants to exercise caution. If something feels off about your interactions, we encourage you to suspend or cease communications. If you are unsure of the legitimacy of a communication you have received, please reach out to ITsupport@Avesis.com.

To learn more about protecting yourself from fraudulent activity, please refer to this article link (https://consumer.ftc.gov/articles/how-avoid-scam). If you believe you were a victim of fraudulent activity, please contact your local authorities or file a complaint (Link: https://reportfraud.ftc.gov/#/) with the Federal Trade Commission. Avsis is not responsible for any claims, losses, damages, or expenses resulting from unaffiliated individuals of the company or their fraudulent activity.

Equal Employment Opportunity

At Avsis, We See You. We celebrate differences and are building a culture of inclusivity and diversity. We are proud to be an Equal Employment Opportunity employer that considers all qualified applicants and does not discriminate against any person based on ancestry, age, citizenship, color, creed, disability, familial status, gender, gender expression, gender identity, marital status, military or veteran status, national origin, race, religion, sexual orientation, or any other characteristic. At Avsis, we believe that, to operate at the peak of excellence, our workforce needs to represent a rich mixture of diverse people, all focused on providing a world-class experience for our clients. We focus on recruiting, training and retaining those individuals that share similar goals. Come Dare to be Different at Avsis, where We See You!