Molina's Credentialing function ensures that the Molina Healthcare provider network consists of providers that meet all regulatory and risk management criteria in order to minimize liability to the company and to maximize safety for members.
Responsible for coordinating assigned aspects of enterprise-wide credentialing and primary source verification process for practitioners and health delivery organizations according to Molina policy and procedure. Where possible, specific production goals on a weekly or monthly basis will be tracked for each respective accountability. Maintains a high level of confidentiality for provider information.
Duties to include any combination of the following:
Processing Credentialing Applications
• Evaluates credentialing applications for accuracy and completeness based on differences in provider specialty and obtains required verifications as outlined in Molina...
The Workforce Management Supervisor will play a key role in gathering business requirements and driving the implementation of the Nice software across all Strategic Business Units. The goal is for successful forecasting, scheduling and intra-day management of multiple geographically diverse customer contact centers. The Workforce Management Supervisor is also expected to provide research, recommendations and assist with workforce management technology solutions to improve the overall quality and increase efficiency and reduce overall operating costs.
• Responsible for oversight, planning, implementation and monitoring of all call center related performance metrics.
• Responsible for coaching and developing team to ensure adherence to policies and procedures.
• Ability to report and work with senior level leadership team members in discussing operational impacts such as performance, cost and savings.
• Ability to...