Senior Credentialing Representative

Join Our Team at Optum

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

Positions in this function are responsible for all activities associated with credentialing or re-credentialing physicians and providers. Includes processing provider applications and re-applications including initial mailing, review, and loading into the database tracking system ensuring high quality standards are maintained. Conducts audits and provides feedback to reduce errors and improve processes and performance. Responsible for the development of credentialing policies and procedures. May oversee primary source verification activities. Employees in jobs labeled with 'SCA' must support a government Service Contract Act (SCA) agreement.

Schedule: Full time 40 hours, Monday-Friday, 7:30AM-4:00PM

Location: This role is Remote Nationwide

You will enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities

• Process hospital credentialing, provider applications, and re-applications including initial mailing, review and loading into the database tracking system
• Conduct audits and provide feedback to reduce errors and improve processes and performance
• Demonstrate great depth of knowledge/skills in own function and act as a technical resource to others
• Solve complex problems on own; proactively identify new solutions to problems
• Act as a facilitator to resolve conflicts on team
• Perform as key team member on project teams spanning more than own function
• Get ready for some significant challenge. This is a performance driven, fast paced environment where accuracy is key. You'll be helping us confirm to very exacting standards such as NCQA, CMS and state credentialing requirements
• Work does not usually require established procedures
• Works independently
• Mentors others
• Acts as a resource for others
• Coordinates others' activities

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications

• High School Diploma/GED
• 2+ years of healthcare provider credentialing experience
• 2+ years of hospital credentialing experience
• 2+ years of experience in MD staff knowledge
• 2+ years of experience working with compliance workflows and processes, including NCQA policies and practices
• Intermediate level of proficiency with MS Excel and Word

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The hourly pay for this role will range from $20.00 to $36.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.