UnitedHealth Group Credentialing Coordinator - March Vision Care - Woodland Hills, CA or San Bernardino, CA in Woodland Hills, California
Position Description: Welcome to one of the toughest and most fulfilling ways to help people, including yourself.
We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement.
Join us and start doing your life's best work. This is an opportunity that's all about where you've been.
All pretty strong up to now.
It's also an opportunity about what's ahead.
Because on the team at UnitedHealth Group, your potential and your impact can be career changing.
We're building and maintaining extensive provider networks to serve our customers.
Our goal is to attract and secure relationships with the best in every specialty and every community.
As a member of our provider credentialing team, you'll help us vet and document the competencies of physicians and other providers in our networks.
As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 6 leader.Primary Responsibilities:Utilizing the National Committee for Quality Assurance (NCQA) standards, this role is responsible for maintaining a current credentialing database for all participating providers when MARCH Vision Care (MARCH) is delegated for credentialingPersons in this role will perform the primary source verification process for initial and re-credentialingMaintains credentialing procedures that comply with state, federal, health plan, and NCQA standardsMaintains a credentialing database of all contracted providersPerforms primary source verification (PSV) as delegated by health plansPSV includes, but is not limited to compliance with all relevant standards to confirm an applicant’s education, experience, and qualificationsCollects and records appropriate dataMaintains systems to ensure appropriate and accurate updating of provider credentialsWorks with Provider Services Team to obtain necessary information from providersMaintains strict standards of confidentiality appropriate to the credentialing and peer review processParticipates in health plan audits and respond to recommendationsCollects and prepares provider records for Professional Review Committee meetingParticipates in Professional Review Committee meetingsResponds appropriately and professionally to any inbound and outbound communications with provider networkPerforms assigned duties as requested by company Required Qualifications: High School Diploma / GED (or higher) 1+ years of credentialing experience Ability to train daily in the Woodland Hills, CA office for approximately 3 months Knowledge of NCQA credentialing standards Knowledge of best practices and industry standards for credentialing processes Experience with Microsoft Excel (editing, cutting, pasting, filtering, creating lists, simple formulas) Experience with Microsoft Word (creating, editing, and saving documents)Preferred Qualifications: Associate's Degree (or higher) Familiarity with Medicaid Soft Skills: Strong PC skills Excellent written and oral communication skills Ability to work in a fast-paced environmentCareers with MARCH® Vision Care.
Now this is a place where you can bring your compassion and desire to innovate.
MARCH® Vision Care was built with a groundbreaking platform in mind for delivering quality vision care — one that not only focuses on early disease detection, but also uses state-of-the-art technology to help improve communication between members and their doctors.
As part of the UnitedHealth Group family of businesses, we specialize in the administration of vision care benefits for managed care organizations, specifically for government sponsored programs such as Medicaid, Medicare, Medicare-Medicaid Plans, and Healthcare Exchange.
Join our team and you’ll quickly realize this is the opportunity to do your life’s best work.Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer 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.UnitedHealth Group is a drug-free workplace.
Candidates are required to pass a drug test before beginning employment. Keywords: UnitedHealth Group, Credentialing Coordinator, San Bernadino, Woodland Hills, CA, credentialing, healthcare, NCQA b173f217-6db2-4b09-8169-ccaa0c6cbb2b
Credentialing Coordinator - March Vision Care - Woodland Hills, CA or San Bernardino, CA California-Woodland Hills 754200