Cincinnati - Network Review Supervisor

Job Purpose or Scope: Leads Network Review Coordinators to ensure complete credentialing of transportation providers, drivers and vehicles for NEMT brokerage line. Coordinates and distributes assignment of reviews through team and appropriate quality assurance reviews. Leads training of coordinators and reports to Director of Healthcare Compliance on team's productivity and compliance.
Major Responsibilities:
Distributes, assigns and completes qualification reviews of transportation providers on regular and ongoing basis to ensure they continue to meet contractual and regulatory requirements for NEMT Brokerage locations.
Promotes and exemplifies ethical conduct, compliance and performance excellence
Leads initial and ongoing training of Network Review Coordinators
Supervises and reports on quality and productivity of Network Reviews
Updates and distributes Network Review SOPs in consultation with Director of Healthcare Compliance
Collects, analyzes and reports on status application in progress and completion of compliance related tasks, including exclusion screenings, training and vehicle/facility inspections.
Coordinates communication with location regarding network capacity, review status and impact of active/inactive status of providers, drivers and vehicles.
First escalation point for network review questions by coordinators, location and/or providers
Leads communication with CBUC and other business units contributing to Network Reviews
Provides analytical support including data entry, analysis and graphical representation of data using Microsoft Excel and editing and writing reports.
Conducts business related research and reporting by identifying, and gathering relevant information from a variety of sources as directed by the Director of Healthcare Compliance.
Provides guidance and assistance to NEMT network regarding BEP/WBE/MBE certification.
Other credentialing, administrative, support and compliance duties as assigned.
Position Description
Leads and supervises process for transportation provider credentialing, determining if information submitted by vendor fulfills minimum participation standards.
Coordinates and assigns regular and ongoing documentation requests for auditing and ongoing monitoring.
Assist in exclusion screening and deciding it potential hits would exclude individual and/or entity from participating in relevant work.
Ability to work with each department to ensure project timelines are met.
Minimum Education & Certifications Required:
2 year associates degree or equivalate work experience required; 4 year degree preferred
Advanced knowledge of multi-task computer operation in a Windows environment. In particular Windows, based PC systems with an emphasis on Excel proficiency
Ability to proficiently operate a computer with a speed of no less than 35 keystrokes per minute
Experience & Skills Required:
Highly organized with attention to detail
Ability to effectively prioritize multiple tasks and deadlines, with flexibility and capacity to identify and administer competing operational priorities in a changing environment with creativity and resourcefulness
Ability to supervise and motivate team to meet deadlines and standards of excellence
Ability to define issue, interpret data and define options
Excellent verbal, interpersonal, judgment and problem-solving abilities
Ability to undertake assignments with minimum supervision and direction
Ability to lead team effectively and interact diplomatically with a wide variety of people
Ability to accurately conduct primary and secondary research
Awareness of change and the capacity to develop additional skills as required
Ability to communicate clearly in the English language
Meets all Qualifications and Job Requirements and understands all Role and Responsibilities
Professional corporate experience and professional demeanor
Transportation or healthcare experience preferred, but not required
Experience with auditing or documentation verification preferred, but not required

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