Supervisor Credentialing Enrollment

Under the direction of the Manager, Credentialing, Supervisor Credentialing Enrollment drives credentialing enrollment specialist team, working to ensure production standards, timelines, quality, and completion of credentialing enrollment functions. Ensures credentialing records are accurately maintained pursuant to internal and external audit standards. Plans, coordinates, and organizes the workload relative to process, production, and procedure adherence to provide the most efficient and accurate results. Serves as a resource for Provider Network Solutions (PNS) division responding to inquiries about credentialing processes and status inquiries. Supports direct engagement with providers and their designees regarding questions related to credentialing. Responsible for reviewing credentialing processing against mandatory health plan accreditation elements to ensure accuracy and completeness prior to Corporate Credentialing Committee review for network enrollment and participation.

** This position is eligible to work hybrid (9 or more days a month onsite) in accordance with our Telecommuting Policy. Applicants must reside in Kansas or Missouri or be willing to relocate as a condition of employment.

• Lead and Inspire: Guide and mentor your team to achieve their full potential and success.
• Family Comes First: Total rewards package that promotes the idea of family first for all employees.
• Professional Growth Opportunities: Advance your career with ongoing training and development programs.
• Dynamic Work Environment: Collaborate with a team of passionate and driven individuals.

• Blue Cross and Blue Shield of Kansas offers excellent competitive compensation with the goal of retaining and growing talented team members. The salary range for this role is a good faith estimate, it is estimated based on what a successful candidate might be paid. All offers presented to candidates are carefully reviewed to ensure fair, equitable pay by offering competitive salaries that align with the individual's skills, education, experience, and training. The range may vary above or below the stated amounts.

• Accountable for performance monitoring, policy enforcement, termination process, disciplinary action, hiring, compliance and team development. Maintaining accurate records of all hiring, firing and disciplinary actions.

• Understand and interpret credentialing compliance rules and regulations and apply to credentialing applications and processing.
• Ensures all credentialing activities are completed according to accreditation standards and are aligned with accreditation, corporate, and federal compliance requirements.
• At the direction of the Manager, Credentialing, responsible for the daily operations of credentialing enrollment oversight, designing and monitoring the workload and performance to meet departmental/corporate goals and objectives.
• In collaboration with the Manager, Credentialing; design and assess procedures, training, and competency metrics by continually reviewing corporate goals, objectives, and regulatory/compliance requirements.
• Create and maintain a good working relationship with all areas that are involved with provider credentialing, providing constructive feedback to improve workflow and efficiencies between units and departments.
• Provide feedback to Manager, Credentialing regarding recommendations to improve the performance and accuracy of the credentialing enrollment personnel.
• Continually analyze processes for development and process improvement, write and update production work procedures.
• Counsels and coaches team members who are below standard performance or situations where corporate policies are not followed. Design and provide focused training opportunities needed because of performance concerns.
• Encourages and recognizes team members for maintaining or improving performance or process improvements that enhance our network enrollment experience.
• Leads team meetings and unit training sessions as needed.
• Assist and act as backup for Manager, Credentialing as required.

• Must be able to learn and apply all credentialing requirements for multiple professional licenses and facility types.
• Ability to understand and apply all elements of the Credentialing Program Plan Charter and credentialing criteria policies.
• Ability to understand, ensure, and apply confidentiality requirements and standards.
• Advanced decision-making techniques, situational appraisal and problem-solving. This is to include the ability to switch topics, systems, or contract applications at a moment’s notice.
• Must complete annual accreditation standards education/training on job functions that is included as part of the adopted and in place health plan accreditation. Must be able to follow required accreditation standards as required for essential job functions.
• Commitment to quality improvement and achievement of goals set for the unit team as well as the department.
• Identify opportunities for skill development, seeking and promoting continual education opportunities relative to job responsibilities as well as encouraging growth to support career development.
• Ability to understand and interpret corporate policies and government regulatory requirements relative to provider enrollment and credentialing.
• Ability to communicate positively, both verbally and written.
• Must embrace and demonstrate the company’s core competencies and values of integrity, dependability, service, growth and progress, and courage.

• High school graduate or equivalent required. Additional education in communications, human relations, or medical terminology preferred.

• One year of operational experience within BCBSKS to include credentialing, or 2 years demonstrated experience working with medical insurance or provider licensing is required.
• Strong computer skills to operate effectively with company systems and programs.
• Excellent verbal and written communication and human relation skills with the ability to interact positively at all levels of internal and external peers.
• Ability to work well under pressure and meet deadlines.
• Work requires good organizational and multi-tasking skills and ability to work both independently and cooperatively within team setting.
• Position is mostly stationary, involving the handling of incoming phone calls and spending approximately 85% of the workday using a PC. Minimal Lifting required.
• Position will be eligible for business area defined hybrid status.

• Base compensation is only one component of your competitive Total Rewards package
  • Incentive pay program (EPIP)
  • Health/Vision/Dental insurance
  • 6 weeks paid parental leave for new mothers and fathers
  • Fertility/Adoption assistance
  • 2 weeks paid caregiver leave
  • 5% 401(k) plan matching
  • Tuition reimbursement
  • Health & fitness benefits, discounts and resources