Job Summary
Molina's Credentialing function ensures that the Molina Healthcare provider network consists of providers that meet all regulatory and risk management criteria to minimize liability to the company and to maximize safety for members. This position is responsible for the initial credentialing, recredentialing and ongoing monitoring of sanctions and exclusions process for practitioners and health delivery organizations according to Molina policies and procedures.  This position is also responsible for meeting daily/weekly production goals and maintaining a high level of confidentiality for provider information.

Job Duties

• Reviews and processes daily alerts for federal/state and license sanctions and exclusions reports to determine if providers have sanctions/exclusions.
• Reviews and processes daily alerts for Medicare Opt-Out reports to determine if any provider has opted out of Medicare.
• Reviews and processes  daily NPDB Continuous Query reports and takes appropriate action when new reports are found.

JOB QUALIFICATIONS

Required Education: High School Diploma or GED.

Required Experience/Knowledge Skills & Abilities 
• Experience in a production or administrative role requiring self-direction and critical thinking.  
• Extensive experience using a computer -- specifically internet research, Microsoft Outlook and Word, and other software systems.  
• Experience with professional written and verbal communication.       

Preferred Experience: 
• Experience in the health care industry
• Experiece with Provider credentialling

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