What are the responsibilities and job description for the Credentialing Specialist - REMOTE position at Molina Healthcare Group?
Job Description
Job Description
Job Summary
Molina's Credentialing function ensures that the Molina Healthcare provider network consists of providers that meet all regulatory and risk management criteria to minimize liability to the company and to maximize safety for members. This position is responsible for the initial credentialing, re-credentialing and ongoing monitoring of sanctions and exclusions process for practitioners and health delivery organizations according to Molina policies and procedures. This position is also responsible for meeting daily/weekly production goals and maintaining a high level of confidentiality for provider information.
Responsible for coordinating assigned aspects of enterprise-wide credentialing and primary source verification process for practitioners and health delivery organizations according to Molina policy and procedure. Where possible, specific production goals on a weekly or monthly basis will be tracked for each respective accountability. Maintains a high level of confidentiality for provider information. Typically assigned the more complex work; works on special projects as assigned; and serves as a "mentor" to newly hired Associate Specialists.
Job Duties
- Processing Credentialing Applications
Recredentialing/Termination
Ongoing Monitoring/Watch Follow-up
Job Qualifications
Required Education:
High School Diploma or GED
Required Experience/Knowledge Skills & Abilities:
Certified Provider Credentialing Specialist (CPCS) or participation in a CPCS progression program.
Preferred Education:
Bachelor's Degree in a related field
Preferred Experience:
Previous experience leading, guiding, or mentoring others.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Job Info
Job Identification: 2030005
Job Category: Network Operations
Posting Date: 2025-01-29T22:30:30 00:00
Job Schedule: Full time