Job Description

Job Summary
The purpose of the credentialing program is to ensure the Molina provider network consists of providers that meet regulatory and risk management criteria to minimize liability to the company and to maximize safety for members.  This position is responsible for supervising the day-to-day operations of the credentialing team to ensure work is completed timely, key performance indicators are met, and ensure compliance with policies and procedures.

Job Duties

• Supervise day to day operations of the Credentialing Department, daily monitoring of production, quality and aging reports, redirecting resources, assigning work to ensure all production standards are met/exceeded and adequate coverage during business hours.  
•  Weekly coaching and motivating employees to ensure all key performance standards are met.  Deliver disciplinary action when needed.
• Interviewing and hiring staff.
• Collaborate with and keep the credentialing leadership team appraised of operational issues, staffing resources, system and program needs.   
• Act as a liaison to internal and external customers on behalf of the Credentialing Department to ensure open communication, effective interface, and prompt resolution of identified issues.  
• Develop standard operating procedures and other materials for credentialing staff to maximize efficiency and productivity. 
 

Job Qualifications

Required Education:

• High school diploma or GED required.  
 

Required Experience:
• 4-years’ experience in Credentialing.
•   Required knowledge of Medicaid, CMS, NCQA and other credentialing regulations.
• Experience leading employees, preferably in a production-related role.
• Demonstrated adaptability and flexibility to changes and response to new ideas and approaches. 
• Strong problem-solving skills including root cause analysis and prompt resolution.
• Excellent interpersonal and communication skills (verbal and written). 
• Must have strong PC skills (Word, Excel, Outlook, PowerPoint)
• Must have strong presentation and leadership skills.

Required License, Certification, Association:

Preferred Certified Provider Credentialing Specialist (CPCS) or, participation in a CPCS progression program. 

Preferred Education:  • Bachelor’s degree in a related field or equivalent combination of education and experience required       

Bachelor's Degree

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.