Associate Director Dental Credentialing/Compliance

Profile

Description

The Associate Director, Credentialing/Compliance manages the Dental Credentialing and Compliance team ensuring that dental providers are Credentialed/Re-credentialed according to CMS and State guidelines and that Humana's Dental Networks operate in compliance with all state and federal regulations.. The Associate Director, Credentialing/compliance requires a solid understanding of the requirements of Dental Credentialing/Recredentialing, strong leadership skills and effective collaboration across multiple department(s) and external vendors/associations.

Responsibilities

The Associate Director, manages a Credentialing team whose members review dental applicant's Credentialing applications to ensure completeness and accuracy of the applications. These team members work directly with dental providers to assist with the process and ensure that all dental providers have active and current Credentials. Decisions are typically related to the analysis of risk to Humana, working collaboratively with the Compliance and Regulatory area as well as Dental Contracting and Operations and leads multiple managers or highly specialized professional associates.

Required Qualifications

Bachelor's Degree or equivalent experience

2 years of management experience

2 years Credentialing, Compliance and regulatory experience (ie: reviews and audit)

Proven leadership skills and significant experience directly managing a group of seasoned professionals.

Process Mapping Skills

Demonstrated success working in collaboration with multiple departments and disciplines.

Strong computer skills including MS Office desktop applications (Word, Excel, PowerPoint, Visio, Project)

Demonstrated competency in both oral and written communication skills.

Solid understanding of process / work flow concepts.

Excellent interpersonal and teamwork skills.

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

Master's Degree in Business, Finance or related fields

Additional Information

This position is open to working remote. These requirements include:

Must have a separate room with a locked door that can be used as a home office to ensure you have absolute and continuous privacy while you work

Must provide a high speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com