Medical Staff Credentialing Supervisor jobs in Oregon

Let’s do great things, together!

About Moda
Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together.

Please fill out an application on our company page, linked below, to be considered for this position.

Benefits:

• Medical, Dental, Vision, Pharmacy, Life, & Disability
• 401K- Matching
• FSA
• Employee Assistance Program
• PTO and Company Paid Holidays

Required Skills, Experience & Education:

• Bachelor’s degree or work experience leading a team in a health-related organization.
• Minimum of 2 years work experience in the Quality Management/Credentialing field.
• Minimum of 2years supervisory experience in a relevant field.
• CPMSM or CPCS certification from NAMSS preferred.
• Working knowledge with NCQA, CMS, and DMAP credentialing standards.
• Proficiency in Microsoft Office products.
• Ability to lead a team with positive interactions.
• Strong/above standard communication skills (verbal, written and interpersonal).
• Ability to work well under pressure with constantly shifting priorities.
• Ability to come into work on time, on a daily basis.
• Ability to maintain confidentiality and project a professional business image.

Primary Functions:

• Supervises staff by providing daily work direction, vacation scheduling, attendance monitoring, and performance reviews.  Hire and train new employees.
• Develops and implements work performance standards, reporting and process improvement activities.
• Supervises credentialing and re-credentialing activities for providers.
• Provides leadership to the team on established credentialing processes.
• Manages credentialing delegations by auditing procedures and processes, as well as remains a continued liaison with Medical Groups and IPAs throughout the State.
• Oversees all health delivery organizations with which company has contracts with by auditing their procedures and processes, and by attending meetings with the QM staff of these health delivery organizations.
• Represents the team on appropriate internal committees and external committees associated with credentialing.
• Works with Medical Director(s), QI Manager and other staff to build physician performance files.
• Performs other duties as assigned.

• Office environment with extensive close PC and keyboard work, constant sitting, and phone work. Must be able to navigate multiple screens. Work in excess of 40 hours per week, including evenings and occasional weekends, to meet business need.
• ​​​​​Internally with own multiple departments.  Externally with providers, provider offices, IPA administrators, Healthcare Delivery Organization administrators and staff, Oregon Credentialing Network, and hospital medical staff.
   

Together, we can be more. We can be better.
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Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. 

For more information regarding accommodations please direct your questions to Kristy Nehler and Daniel McGinnis via our humanresources@modahealth.com email.