VisionWeb Credentialing Supervisor

Job description

Requisition ID:  834715 
Position: Full-Time

 

We are EssilorLuxottica, a global leader in the design, manufacture and distribution of ophthalmic lenses, frames and sunglasses. The Company brings together the complementary expertise of two industry pioneers, one in advanced lens technologies and the other in the craftsmanship of iconic eyewear, to create a vertically integrated business that is uniquely positioned to address the world’s evolving vision needs and the global demand of a growing eyewear industry.
 

With over 180,000 dedicated employees in 150 countries driving our iconic brands, our people are creative, entrepreneurial and celebrated for their unique perspectives and individuality. Committed to vision, we enable people to “see more and be more” thanks to our innovative designs and lens technologies, exceptional quality and cutting-edge processing methods. Every day we impact the lives of millions by changing the way people see the world.

 

Our portfolio of more than 150 renowned brands span various categories, from frames, lenses and instruments to brick and mortar and digital distribution as well as mid-range to premium segments. Our Shared Services Team, accompany and enable others within the EssilorLuxottica collective to achieve their targets. They keep people and projects running smoothly, ensuring every part of our business is provided for and well taken care of.

GENERAL FUNCTION

The Credentialing Supervisor is responsible for ensuring efficient and accurate provider enrollment applications are submitted for over providers and/or medical practitioners to medical and vision insurance carriers in a timely manner. Supervises the daily operational needs and services related to the payer enrollment process and represents interests to all types of payers including federal and state government agencies/programs. This position is responsible for the day-to-day operations of the Credentialing department including process and workflow of the provider enrollment specialists. Implements action plans to carry out department objectives and strategy.

 

MAJOR DUTIES AND RESPONSIBILITIES

·  Acts as a liaison to the Sr. Manager to assist in ensuring provider cooperation and understanding of financial ramifications related to delayed or incorrect credentialing.
·  Interviews, hires, trains, evaluates and develops subordinate management staff in accordance with defined policies and objectives.
·  Provide feedback regarding potential changes or enhancements to improve staff performance and ensure work quality has a positive impact.
·  Responsible for ensuring the department possesses relevant knowledge of credentialing requirements for various health plans and states.
·  Creates credentialing policies and procedures as needed.
·  Oversees and directs all daily activities in support of the departmental goals and objectives, and is responsible for directing, motivating, monitoring, measuring and developing employees.
·  Serves as the primary point-of-contact for day-to-day credentialing issues.
·  Supervises and Assists with Credentialing audits.
·  Works closely with the Sr. Manager/Director to ensure the timely onboarding/enrollment of new providers and the re-credentialing/validation of existing providers are maintained in CAQH.
·  Participate in focus groups that analyze and predict the potential impact of new providers onboarding with the organization to document processes that support any changes.
·  Ensure all duties comply with all regulatory and accreditation standards including The Joint Commission, the National Committee Quality Assurance (NCQA) guidelines, to include Medicare and state Medicaid plans.
·  Report issues in a timely manner to Sr. Manager for decision making in accordance with credentialing and privilege policy and federal state, local, and government and health plans standards.
·  Uphold and ensure compliance, confidentiality and adhere to all HIPAA guidelines, and maintain a strict level of confidentiality.
·  This role is a key member of the RCM department with involvement in decisions affecting all other departments and can be expected to generate and present to senior leadership analysis and recommendation to enhance organizational effectiveness.
·  Perform other job-related duties as assigned.

 

BASIC QUALIFICATIONS

·  Required Education: Associate degree and/or 3 – 5 years related work experience. A working knowledge of federal and state regulatory agencies and accrediting bodies (CMS, TJC, NCQA, etc.)

 

REQUIRED EXPERIENCE

3-5 years of leadership experience in a directly related role.

Employee pay is determined by multiple factors, including geography, experience, qualifications, skills and local minimum wage requirements. In addition, you may also be offered a competitive bonus and/or commission plan, which complements a first-class total rewards package. Benefits may include health care, retirement savings, paid time off/vacation, and various employee discounts. 
 
Upon request and consistent with applicable laws, EssilorLuxottica will provide reasonable accommodations to individuals with disabilities who need assistance in the application and hiring process.  To request a reasonable accommodation, please call the Luxottica Ethics Compliance Hotline at 1-888-887-3348 (be sure to provide your name and contact information so that we may follow up in a timely manner) or email HRCompliance@luxotticaretail.com. 
  
We are an Equal Opportunity Employer.  All qualified applicants will receive consideration for employment without regard to race, color, gender, national origin, social origin, social condition, being perceived as a victim of domestic violence, sexual aggression or stalking, religion, age, disability, sexual orientation, gender identity or expression, citizenship, ancestry, veteran or military status, marital status, pregnancy (including unlawful discrimination on the basis of a legally protected pregnancy or maternity leave), genetic information or any other characteristics protected by law. Native Americans in the US receive preference in accordance with Tribal Law.

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Nearest Major Market: Austin
Job Segment: Medicaid, Medicare, Manager, Ophthalmic, Healthcare, Management

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