Delegation Oversight Coordinator Credentialing at Health Care Service Corporation

Tulsa, Oklahoma, United States -

Full Time

Start Date

Immediate

Expiry Date

30 Jan, 26

Salary

110000.0

Posted On

01 Nov, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Credentialing Operations, Auditing, Project Management, Regulatory Requirements, Communication Skills, Organizational Skills, PC Proficiency, Leadership, Corrective Actions, Data Analysis, Trend Analysis, Report Creation, Feedback Provision, Delegated Oversight, Accreditation Standards, Multi-Priority Handling

Industry

Hospitals and Health Care

Description

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job Summary This position is responsible for leading, coordinating and participating in Credentialing delegation oversight audits of HCSC’s vendors, service providers, medical groups and/or delegated subcontracted providers reviewing adherence to regulatory and contractual requirements. The position also develops audit tools based on Credentialing/Re-credentialing operations, state and federal regulations, conducts the reviews in accordance with accreditation standards and Credentialing guidelines. Creates reports regarding audits, and analyzes tracks and trends audit findings. Develops and monitors corrective actions and provides feedback to practitioners on performance. Required Job Qualifications: Associate Degree in Business or Medical OR 3 or more years’ experience in a managed care environment. 2 years in a leadership role that includes direct accountability and responsibility and direction of staff. 4 years’ experience in directly involved in Credentialing operations performing delegated oversight activities. 4 years auditing Credentialing file or Credentialing operational experience Project Management skills and experience. Knowledge of regulatory/accreditation requirements and standards (Department of Insurance, NCQA, URAC). Verbal and written communication skills. Organizational skills and the ability to handle multiple priorities. PC proficiency to include Word, Excel, PowerPoint, Adobe Acrobat, and Outlook. Ability to travel (up to 30-40%) Including overnight stays Preferred Job Qualifications: Bachelor Degree in Business or Medical. Knowledge of Power Point, Visio and Access. College level courses or certification in project management. Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process! Pay Transparency Statement: At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards. The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. HCSC Employment Statement: We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. Base Pay Range $49,800.00 - $110,000.00 Exact compensation may vary based on skills, experience, and location. Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities. Join our Talent Community. For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren’t afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you’ll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations. Please note that only requests for accommodations in the application process will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions. Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.

Responsibilities

This position is responsible for leading and coordinating Credentialing delegation oversight audits of HCSC’s vendors and providers. The role involves developing audit tools, conducting reviews, creating reports, and monitoring corrective actions.