Job Description

Job Description

Job Description

About Our Company

At Altais, we're looking for bold and curious innovators who share our passion for enabling better health care experiences and revolutionizing the healthcare system for physicians, patients, and the clinical community. At Altais, we’re building breakthrough clinical support tools, technology, and services to let doctors do what they do best: care for people. We invite you to join our growing passionate team as we change the game for the future of healthcare and enable the experience that people need and deserve. Altais family of companies include: Brown & Toland Physicians, Family Care Specialists and Altais Medical Groups.

About Your Team

Are you looking to work with a high performing, fast growing and dynamic Credentialing team? We are 4,000+ physicians, working in over 40 cities throughout California, caring for more than 500,000 patients. If you are passionate about reshaping healthcare and want to work for a mission driven organization where new ideas and innovation are valued, then we would like to meet you.

This position is located in our brand-new Oakland City Center location, or remotely (within the state of California). We are flexible provided you are open to traveling to the Oakland office locations as needed.

About Your Work

The Credentialing Audit Specialist I is responsible for supporting daily audits of credentialing packets. This individual will work closely with internal teams to provide education and support for improve of credentialing and recredentialing process. This will include developing training materials for process including application, credentialing, recredentialing, audit and compliance.

You will focus on:

• Responsible for all aspects of the daily auditing functions processing to review accuracy and timeliness in accordance with BTP policies and procedures, health plan delegation requirements and NCQA standards. Prepare credentialing files and monthly matrices for presentation to the Credentialing Committee; responsible for confirming the completeness of information and all documentation prior to presentation.
• Working with manager and supervisor develop a feedback loop to credentialing coordinator, specialists and manager on audits including corrective action plans, opportunities for improvement for employees and processes and reporting.
• Responsible for developing professional training materials to be used to onboard resources.
• Responsible for creating training materials associated with sPayer including recruiting, application, credentialing and recredentialing processes.
• Responsible for engaging manager on review and approval of training materials.
• Develop a credentialing calendar for audits to trigger activities; and create tracking mechanism to track audits.
• As needed, support developing documentation associated with each health plans roster process and data needs.
• As needed, support high priority credentialing and recredentialing applications as defined by manager.

The Skills, Experience & Education You Bring

• Bachelor’s degree or equivalent to 4 year university degree, preferably in healthcare related field of study.
• 5+ years professional experience working in credentialing, provider data management or provider relations, preferably in a managed care setting required.
• Independently researches and resolves issues.
• High level of organizational skills and attention to detail.
• Provider data management experience.
• Knowledge of medical credentialing and privileging procedures and standard.
• Excellent communication skills, both written and verbal, as well as strong organizational and administrative abilities.
• Strong ability to multitask and meet or exceed turnaround time standards.
• Ability to handle sensitive information with discretion and confidentiality.

You Share our Mission & Values

• You are passionate about improving the healthcare experience and want to be part of the Altais mission.
• You are bold and curious - willing to take risks, try new things and be creative.
• You take pride in your work and are accountable for the quality of everything you do, holding yourself and others to a high standard.
• You are compassionate and are known as someone who demonstrates emotional intelligence, considers others when making decisions and always tries to do the right thing.
• You co-create , knowing that we can be better as a team than individuals. You work well with others, collaborating and valuing diversity of thought and perspective.
• You build trust with your colleagues and customers by demonstrating that you are someone who values honesty and transparency.

Altais values the contribution each Team Member brings to our organization. Final determination of a successful candidate’s starting pay will vary based on several factors, including, but not limited to education and experience within the job or the industry. The pay scale listed for this position is generally for candidates that meet the specified qualifications and requirements listed on this job description. Additional pay may be determined for those candidates that exceed these specified qualifications and requirements. We provide a competitive compensation package that recognizes your experience, credentials, and education alongside a robust benefits program to meet your needs.

The anticipated pay range for this role is listed in our salary posting for transparency but may vary based on factors including the candidate’s qualifications, skills, experience, and geographic location. This base pay range is specific to California and can vary based on Bay Area, Metro LA, and Greater California regions which may not be applicable to other locations.

Altais and its subsidiaries and affiliates are committed to protecting the privacy and security of the personal information you provide to us. Please refer to our ‘CPRA Privacy Notice for California Employees and Applicants’ to learn how we collect and process your personal information when you apply for a role with us.

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork – Activity level: Sedentary, frequency most of workday.

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.

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