Abilities

Responsibilities include, but are not limited to:

• Ensure strict HIPAA-compliant confidentiality with all healthcare-related data
• Manage and review onboarding documentation
• Set up and manage provider information in multiple platforms
• Verify NPI’s and other provider enrollment information
• Complete, submit, and follow up on credentialing requests and applications on a regular schedule that will result in faster turnaround times
• Apply for provider licenses in collaboration with the provider
• Ensure applications are full and complete and monitor submitted license applications weekly
• Experience with licensing platforms, i.e IMLC, eNLC, state board websites
• Supporting the compliance team with periodic reviews of NCQA policies
• Serve as licensing and credentialing subject matter resource internally and externally
• CAQH ongoing maintenance/ management
• Resolve any deficiencies with credentialing or licensing in compliance with regulatory requirements.
• Assist in interpreting state requirements and communicate with state licensing boards as needed.
• Advanced skills in Excel and Google Sheets
• Familiar with Internal credentialing process and Committee meetings
• Interact with the Valera Health team in a manner that promotes teamwork, customer service and collaboration
• Other duties as assigned

Preferred Qualifications

2 years of provider credentialing and licensing experience in a healthcare setting required

Home office capabilities (including secure internet access and private place to work)

Bachelor’s degree or Certification preferred

Talents/Strengths

• Decisiveness and attention to detail: you can catch even the smallest errors
• Multi-tasking: you can seamlessly manage multiple projects with different timelines and varying processes
• Resourceful: you usually have the answer, but when you don’t, you know where to find it
• Responsiveness: you respond quickly to partners, clinicians, and co-workers. You hate to keep others waiting and feel satisfied knowing your specialized knowledge helps the team succeed
• Continuous improvement mindset: you are always looking for ways to go from “good” to “great” in order to support team efficiency

Fair work deserves fair wages. At Valera, we value this role starting at non-exempt rate starting between $47k-$50k annually with the potential for an annual performance bonus.