Job Description

Independently requests and reviews primary source information and verifications. Identifies and plans for resolution of moderately complex gaps in vendor relationships and escalates, as needed. Serves as a main point of contact for external queries regarding practitioner status. Evaluates applications and supporting complex documents. Applies and begins to suggest improvements to credentialing and privileging processes. Evaluates moderately complex practitioner sanctions. Participates in surveys and audits of credentialing entities. Facilitates cost-effective due process. Conducts audits of data between different departments. Conducts the facilitation and orientation and training to newly appointed physician leaders. Develops moderately complex informational documents. Maintains working relationships with key stakeholders. Maintains awareness of policies and provides moderately complex consultations. Processes moderately complex provider enrollment information. Gathers and independently communicates relevant information to appropriate parties. Proactively ensures, guides others, and improves processes to enact control of data systems and applications. Independently analyzes data. Maintains moderately complex structures database structures and data.Essential Responsibilities:Promotes learning in others by proactively providing and/or developing information, resources, advice, and expertise with coworkers and members; builds relationships with cross-functional/external stakeholders and customers. Listens to, seeks, and addresses performance feedback; proactively provides actionable feedback to others and to managers. Pursues self-development; creates and executes plans to capitalize on strengths and develop weaknesses; leads by influencing others through technical explanations and examples and provides options and recommendations. Adopts new responsibilities; adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; champions change and helps others adapt to new tasks and processes. Facilitates team collaboration to support a business outcome.