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Credentialing and Delegation Analyst- Bowie, MD; Tampa, FL or South FL area

LOCATION: Remote
REMOTE ELIGIBLE: Partial Remote
REQUISITION ID: 905
<p><a href="https://www.youtube.com/watch?edufilter=NULL&amp;v=x2VAeHGPp1s">Data has a story to tell. We give it a voice.</a></p> <p>&nbsp;</p> <p><strong>This role will be remote to start and move to partial remote/office based in the Bowie, MD or Tampa, FL office (or within the South FL area to be remote) at a later date (the selected candidate must currently be within a commutable distance to Bowie, MD office; Tampa, FL office or living in the South FL area)</strong></p> <p>Inovalon is a growing, nimble organization with a team of employees who are passionate to carry out our mission of delivering high-value solutions to a marketplace that is undergoing an important transformation to data-driven healthcare. We value having people who are committed to our core values to I.N.S.P.I.R.E. We care about your career development and growth. Through our learning culture, we are motivated to provide opportunities to all our employees to improve and gain new skills that will help elevate their career. We value having go people on our team, and we do our part to make sure to give the recognition deserved for every contribution. If this sounds like the kind of company you’d like to work with, we’d love to meet with you!</p> <h4>Here’s what an ordinary day of work might look like</h4> <ul> <li>Review and validate accuracy of credentialing applications and supporting documentation prior to submission for primary source verification (“PSV”) of credentials</li> <li>Conduct and/or validate the accuracy of PSVs</li> <li>Prepare credentialing files for the Medical Director and/or the Credentialing Committee’s to review for decisioning</li> <li>Maintain credentialing documentation in application systems and secure drive location(s)</li> <li>Credential all files in accordance with federal, state and NCQA requirements as well as client specific and policy level requirements</li> <li>Assist in developing and performing internal audits and risk assessments</li> <li>Complete client level audit documentation requests which may include file, policy and procedural reviews</li> <li>Evaluate processes and procedures to assess performance against client commitments and internal performance and compliance standards</li> <li>Prepare, audit and distribute client specific rosters according to corporate requirements</li> <li>Assess business risks and control environment and recommend enhancement opportunities</li> <li>Perform compliance and quality program and project support</li> <li>Fulfill additional assignments and responsibilities as needed</li> <li>Maintain compliance with Inovalon’s policies, procedures and mission statement</li> <li>Adhere to all confidentiality and HIPAA requirements as outlined within Inovalon’s Operating Policies and Procedures in all ways and at all times with respect to any aspect of the data handled or services rendered in the undertaking of the position</li> <li>Fulfill those responsibilities and/or duties that may be reasonably provided by Inovalon for the purpose of achieving operational and financial success of the Employer</li> <li>Uphold responsibilities relative to the separation of duties for applicable processes and procedures within your job function</li> </ul> <h4>This job is for you if</h4> <ul> <li>Have a bachelor’s degree or equivalent work experience is required</li> <li>Minimum of 3 years of healthcare provider credentialing experience and 2 years of auditing or quality management experience</li> <li>Comprehensive knowledge and understanding of Centers for Medicare &amp; Medicaid Services, NCQA and URAC Credentialing, Delegation and Quality Improvement requirements</li> <li>Experience monitoring license/board certifications (completing monthly auditing)&nbsp;</li> <li>Solid business analytical skills including process flow, spreadsheets, modeling, procedures</li> <li>Experience in the healthcare industry</li> <li>Flexible/adaptable disposition with a can-do attitude</li> <li>Strong proficiency with Microsoft Office Suite (Word/Excel/Outlook) as well as prior use of credentialing databases</li> <li>Excellent verbal and written communication skills</li> <li>Analytical mindset with excellent organizational skills</li> <li>Ability to work independently and complete assigned tasks when working remote&nbsp;</li> </ul> <p><em>Inovalon is proud to be an equal opportunity workplace and is an affirmative action employer. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status. We also consider qualified applicants regardless of criminal histories, consistent with legal requirement.</em></p> <h4>What are you waiting for? Apply now!</h4> <p>Are you getting jazzed up by the thought of working with us? Don’t hesitate! Apply now! We believe in the power of data, informing actionable insights, driving meaningful impact and making healthcare better. If you can work in a fast-paced, team-oriented environment, we would love to have you join our team. Apply now to complete our online application. You will need to upload a recent copy of your resume. If you don’t have the qualifications we have asked for, this position isn’t for you, and we will not be able to consider your application.</p><div class="content-conclusion"><p><em>By embracing diversity, equity and inclusion we enhance our work environment and drive business success. Inovalon strives to reflect the diversity of the communities where we operate and of our clients and everyone whom we serve. We endeavor to create a culture of inclusion in which our associates feel empowered to bring their full, authentic selves to work and pursue their professional goals in an equitable setting. We understand that by fostering this type of culture, and welcoming different perspectives, we generate innovation and growth.</em></p> <p><em>Inovalon is proud to be an equal opportunity workplace and is an affirmative action employer. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status. We also consider qualified applicants regardless of criminal histories, consistent with legal requirement.</em></p> <p><em>The Company maintains a drug free work environment for all of its associates, which includes employees, contractors and vendors. It is unlawful for associates to manufacture, sell, distribute, dispense, possess or use any controlled substance or marijuana in the workplace and doing so will result in disciplinary action, up to and including termination of employment or the contracted relationship.</em></p> <div><em>Consistent with Inovalon’s safety protocols, the company will require a vaccination attestation for fully office-based and hybrid (office/remote) positions. Positions designated as fully remote are exempt from the attestation requirement unless and until such time as an in-office presence is required.</em></div> <p>&nbsp;</p></div>

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