GEHA (Government Employees Health Association, Inc., pronounced G.E.H.A.) is a nonprofit member association that provides medical and dental benefits to more than two million federal employees and retirees, military retirees and their families. We celebrate diversity and are committed to creating an inclusive environment for all employees.

GEHA has one mission: To empower federal workers to be healthy and well.

Offering one of the largest medical and dental benefit provider networks available to federal employees in the United States, GEHA empowers health and wellness by meeting its members where they are, when they need care. We serve our members with products they value and a personalized customer experience, sustained by a nimble and efficient organization.

Administers the daily operations of the Credentialing department. Works under the indirect supervision of the Manager, Provider Network. Responsible for managing the credentialing process for Dental Service Organizations, dental groups and individual dentists. Participates on the Quality Assurance Committee to review contract compliance and suspension of participating providers which poses a risk to the health, welfare, or safety of consumers. Oversees all client and dental provider audits. Responsible for ensuring that the credentialing process meets accreditation and applicable state laws.

SKILLS

Duties and Responsibilities:

• Supervises the department workflow to ensure quality, quantity and uniformity goals are met.

• Participates on the Quality Assurance Committee to review contract and suspension of participating providers which poses a risk to the health, welfare, or safety of consumers. promotion, termination reassignment of subordinates.

• Schedules and conducts performance reviews.

• Conducts meetings with employees to communicate organizational and departmental changes as necessary.

• Maintains attendance records and approves leave requests.

• Oversees contract between GEHA and CVO and coordinates workflow between entities to ensure all dental providers have been primary source verified and meet all credentialing criteria.

• Develops staff training materials; implements and supervises formal training classes for department.

• Develops and prepares daily, weekly and monthly credentialing reports and management reports.

• Assists Manager, Provider Network planning, implementing and controlling departmental budget.

• Develops and administers departmental policies and procedures.

• Responsible for maintaining credentialing criteria, accreditation and credentialing legal policies and procedures.

• Responsible to facilitate the accreditation process.

• Consults with Vice Presidents, Directors, Managers, and outside vendors to determine future departmental direction.

• Administers project planning required within the department to accommodate the company's annual business needs as it relates to the department.

• Works with dental network clients on credentialing provider file audits. Analyzes results and makes any necessary changes to current credential process.

• Ensures all state law required credentialing timeframes are met.

Knowledge, Skills, and Abilities:

• Requires a bachelor's degree in business or related field, additional years of qualifying work experience may be considered in lieu of formal education.

• Requires four years’ experience in health care/administration field with credentialing, provider licensing or privileging experience, that includes at least 2 years of supervisory/leadership or similar experience.

• Requires independent decision-making.

• Requires excellent verbal and written communication skills to draft correspondence and talk with health care professionals and other constituencies on the telephone, in-person and virtual meetings.

Work-at-home requirements

• Must have the ability to provide a non-cellular High Speed Internet Service such as Fiber, DSL, or cable Modems for a home office.
• A minimum standard speed for optimal performance of 30x5 (30mpbs download x 5mpbs upload) is required.
• Latency (ping) response time lower than 80 ms
• Hotspots, satellite and wireless internet service is NOT allowed for this role.
• A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

How we value you

• Competitive pay/salary ranges
• Incentive plan
• Health/Vision/Dental benefits effective day one
• 401(k) retirement plan: company match – dollar for dollar up to 4% employee contribution (pretax or Roth options) plus a 6% annual company contribution
• Robust employee well-being program
• Paid Time Off
• Personal Community Enrichment Time
• Company-provided Basic Life and AD&D
• Company-provided Short-Term & Long-Term Disability
• Tuition Assistance Program

Please note that the salary information is a general guideline only. GEHA considers factors such as (but not limited to) scope and responsibilities of the position, candidate’s work experience, education/training, key skills, internal peer equity, as well as, market and business considerations when extending an offer.

The annual base salary range for this position is $62,997 - $88,803 USD.

GEHA is an Equal Opportunity Employer, which means we will not discriminate against any individual based on sex, race, color, national origin, disability, religion, age, military status, genetic information, veteran status, pregnancy, marital status, gender identity, and sexual orientation, as well as all other characteristics and qualities protected by federal, state, or local law. GEHA will not discriminate against employees or applicants because they have inquired about, discussed, or disclosed their compensation or the compensation of another employee or applicant. We are committed to creating an inclusive environment for all employees. Our diversity drives innovation deepens connections and strengthens our organization.

GEHA is headquartered in Lee's Summit, Missouri, in the Kansas City area. We recognize the importance of balance and flexibility and offer hybrid and work-from-home options for many of our roles.