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Manager Credentialing - Remote

Company: UnitedHealth Group
Location: New York
Posted on: November 17, 2023

Job Description:

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. -

Responsible for leading all aspects of credentialing and provider enrollment for an Optum Care Delivery Organization. Effectively communicate with local markets, leadership, and functional business teams to achieve operational efficiencies and foster a proactive and highly responsive provider-centric operating model.

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. -

Primary Responsibilities: -


  • Responsible for credentialing activities including initiation and review of application, primary source verification, processing provider enrollments, re-enrollments and demographic updates with contracted payers, and ongoing monitoring of credentials
  • Assist in the development and administration of policies and procedures related to credentialing activities
  • Set team direction, develop proactive goals and measure team performance against operational targets
  • Use pertinent data and facts to identify and solve a range of problems within area of expertise, and provide guidance to team on non-standard requests
  • Oversee the tracking and maintenance of all provider data in provider data management system, ensuring high quality standards are maintained
  • Conduct ongoing training on credentialing and enrollment procedures for Credentialing Centers of Excellence team
  • Consult with internal and/or external stakeholders to address business needs and reduce operational challenges
  • Conduct audits and provide feedback to reduce errors and improve processes and performance
  • Oversees work activities of other supervisor(s)

    - -You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. -One year of post-high school education can be substituted/is equivalent to one year of experience.

    Required Qualifications: -

    • 4+ years credentialing/payer enrollment experience
    • 3+ years supervisory/leadership experience -
    • Proven government and commercial payer enrollment knowledge
    • Healthcare and Managed Care experience
    • Demonstrated knowledge of credentialing procedures, policies, and terminology (i.e., NCQA)


      Preferred Qualifications: -

      • Ability to effectively prioritize and execute tasks in a high-pressure environment
      • Demonstrated experience leading cross-functional team(s) to achieve operational goals
      • Excellent written and verbal communication skills


        *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy - - -
        California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island or Washington residents is $67,800 to $133,100 per year. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In - addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. -
        - -At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. - - - - -Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. - - -OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment -

Keywords: UnitedHealth Group, New York , Manager Credentialing - Remote, Executive , New York, New York

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