Temporary Provider Services Credentialing Specialist

ABOUT THIS TEMP POSITION

We have two temporary positions that we are looking to fill immediately. The length of assignment is estimated to go for 3-6 months. The length of the assignment is always dependent on business need and dates may change. While the assignment would be at the Alliance, if selected, you would be an employee of a temporary employment agency that we would connect you with.

WHAT YOU'LL BE RESPONSIBLE FOR

Reporting to the Provider Services Credentialing Supervisor, this position:

• Conducting provider credentialing and re-credentialing, including performing Primary Source Verifications
• Researching and analyzing complex credentialing issues and develops and proposes solutions
• Performing ongoing monitoring of physician license status and state and federal sanctions of contracted and non-contracted providers and conducts related investigation

WHAT YOU'LL NEED TO BE SUCCESSFUL

To read the full position description, and list of requirements click here. 

• Knowledge of:
• The methods and techniques of research, analysis and reporting
• The methods and techniques of data entry and data auditing
• The principles and practices of customer service
• Some knowledge of managed care concepts
• Ability to:
  • Interpret, explain and apply policies, procedures, laws, regulations and contract language
  • Identify and troubleshoot issues, gather and analyze information and data, identify alternative solutions and make recommendations for action
  • Enter, proofread, verify, analyze and audit data, and identify data anomalies
• Education and Experience:
  • Bachelor's degree in Business or Public Administration, Public Policy, Health Care or a related field and a minimum of three years of experience performing credentialing, compliance or other regulatory functions in a healthcare or government setting (a Master’s degree may substitute for two years of the required experience); or an equivalent combination of education and experience may be qualifying

OTHER INFORMATION

• We are in a hybrid work environment, and we anticipate that the interview process will take place remotely via Microsoft Teams.
• While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected.
• In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process.
• This is a temporary position and does not provide the benefits that are listed below (it is standard language from our regular job posts and cannot be altered or removed).

The full compensation range for this position is listed by location below. 

The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferrable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location).

OUR BENEFITS

• Medical, Dental and Vision Plans
• Ample Paid Time Off
• 12 Paid Holidays per year
• 401(a) Retirement Plan
• 457 Deferred Compensation Plan
• Robust Health and Wellness Program
• Onsite EV Charging Stations
• And many more

ABOUT US

We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us. 

The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer

Join us at Central California Alliance for Health (the Alliance) is an award-winning regional Medi-Cal managed care plan that provides health insurance for children, adults, seniors and people with disabilities in Mariposa, Merced, San Benito and Santa Cruz counties. We currently serve more than 418,000 members. To learn more about us, take a look at our Fact Sheet.

At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.