Manage analytics and deliverables with Health Plan and Government payers as required by the Commercial payers, Centers of Medicare & Medicaid Services (CMS), Department of Health (DOH) for Quest Diagnostics, its subsidiaries, affiliates, and their respective testing facilities. Drive process compliance, controls and standardization utilizing a Centers of Excellence methodology to support all reporting analytics and Provider Enrollment activities.

Education:

• Bachelor's degree in business administration (preferred), Certification or equivalent

Required Work Experience: 

• 5+ years' relevant experience, including working knowledge of Medicare and Medicaid provider network requirements, enrollment, or third-party payer credentialing
• 5+ years’ experience in Lab Industry and/or Healthcare industry and a comprehensive understanding of highly matrixed organizational structures

Preferred Work Experience: 

• Work experience in Provider Enrollment and Credentialing including understanding of state regulatory requirements for Enrollment submission

Knowledge: 

• Medicare Provider Enrollment, Chain, Ownership System (PECOS)
• State Medicaid Web Portals
• Council for Affordable Quality Healthcare (CAQH) Provider Daily Portal
• National Plan and Provider Enumeration System (NPPES)
• Salesforce.com or comparable CRM Tool
• Credentialing Software

Skills: 

• Strong analytical and critical thinking skills
• Strong written and verbal communication
• Process planning and organization
• Strong technical skills in MS Word and Excel
• Able to multi-task and perform in a fast-paced environment

Equal Opportunity Employer: Race/Color/Sex/Sexual Orientation/Gender Identity/Religion/National Origin/Disability/Vets or any other legally protected status.