Kelsey-Seybold Clinic
Responsibilities:
The Supervisor of Credentialing and Delegation Oversight directs the Credentialing process for the Health Plan, Kelsey Seybold Clinic and PGT and works with delegated entities to ensure credentialing standards are being maintained. He/she completes annual delegation oversight audits for compliance and other projects to meet the requirements of CMS, Texas Department of Insurance, NCQA and AAAHC. They will be responsible for ensuring the Delegates submit routine, timely rosters and adhere to all other aspects of the Delegation Agreement. The Supervisor will also be responsible for the credentialing of providers/facilities by KelseyCare Advantage, Kelsey-Seybold and PGT. He/she works on credentialing standards, policy development, management reporting, collection and analysis of data, and development and presentation of educational programs to improve compliance training programs.
Job Title: Supervisor, Delegation Oversight – PGT
Clinic Location: Pearland Administrative Office Building
Department: Community Network Op
Job Type: Full Time
Salary Range: $37,440 – $71,594 (Pay is based on several factors including but not limited to education, work experience, certifications, etc.)
Qualifications
Education
Required: Bachelor’s degree or equivalent work experience
Preferred: 3 years credentialing experience
Experience
Required: 5 years Health Care or Health Plan experience. Demonstrated knowledge of CMS, TDI, and NCQA criteria for credentialing and delegation.
Preferred: Previous supervisory or management experience in a Managed Care environment
License(s)
Required: N/A
Preferred: N/A
Special Skills
Required: Knowledge of CMS rules and regulations, Managed Care payment methodologies, proficient in MS office products, and process improvement methodology
Preferred: Willingness to learn internal Provider Data Management tools
Other
Required: Excellent written and verbal communication skills
Preferred: Computer literate
Working Environment: Office
About Us
Start your career journey and become a part of a community of renowned Healthcare professionals. Kelsey-Seybold Clinic is Houston’s fastest growing, multispecialty organization with more than 40 premier locations and over 65 specialties. Our clinics are comprised of more than 600 physicians and as we continue to grow, our focus is providing quality patient care by adding to our team of clinical and non-clinical professionals that work together in a convenient, coordinated, and collaborative manner. Enjoy the rewards of a successful career while maintaining a work/life balance by joining our team today and changing the way health cares.
Why Kelsey-Seybold Clinic?
- Medical, Vision, and Dental
- Tuition Reimbursement
- Company Matching 401K
- Employee Reward and Recognition Program
- Paid time off for vacation, sick, and holidays
- Employee Assistance Program
- Continuing Medical Education allowance