At Blue Cross and Blue Shield of Nebraska, we are a mission-driven organization dedicated to championing the health and well-being of our members and the communities we serve.

Our team is the power behind that promise. And, as the industry rapidly evolves and we seek ways to optimize business processes and customer experiences, thereâ??s no greater time for forward-thinking professionals like you to join us in delivering on it!

As a member of Team Blue, youâ??ll find purpose, opportunities and the support you need to build a meaningful career and make a powerful impact in our community.

This position is responsible for processing credentialing data for new and current network providers through data collection and primary source verification required for compliance with URAC Standards, regulatory accreditation standards, Nebraska State statutes, HIPPA regulations and policies/ procedures and for presentation to the Credentialing Committee. Responsible for the maintenance of the credentialing database, coordination with vendor system and provider files, to meet credentialing requirements and deadlines.

As a member of Team Blue, youâ??ll find purpose, opportunities and the support you need to build a meaningful career and make a powerful impact in our community.

BCBSNE is happy to offer four work designations for our Omaha area employees: 100% in-office, Hybrid options, and 100% remote. If choosing to work remote, this role can be located in one of the following states: Florida, Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, and Texas.

What you'll do:

Contact primary sources to verify credentialing and or re-credentialing information.
Analyze practitioner applications for completeness and accuracy.
Evaluate credentialing information against the selection and renewal criteria for each practitioner type, including evaluation of delegated entities.
Track submission of all documents required to begin the credentialing process and for presentation to the Credentialing Committee, by the month and year due.
Evaluate credentialing and re-credentialing information against the URAC Credentialing Criteria for each practitioner type.
Update and maintain provider applications, documents, database, and credentialing files in an organized and timely manner, to facilitate easy retrieval of information, meet credentialing guidelines, and for credentialing reporting purposes.
Compile provider information for medical director review and for Credentialing Committee presentation.

To be considered for this position, you must have:

High School Diploma or equivalent.

An equivalent combination of education and experience may be substituted for this requirement.

The ability to meet or exceed the attendance and timeliness requirements of their departments.

The ability to work well in a team environment, and be capable of building and maintaining positive relationships with other staff, departments, and customers.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and or ability required.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Other duties may be assigned.

The strongest candidates for this position will also possess:

Previous professional work experience or credentialing experience

Learn more about what makes BCBSNE such an exceptional place to work by visiting NebraskaBlue.com/Careers.

We strongly believe that diversity of experience, perspective and background will lead to a better workplace for our employees and a better product for our customers and members.

Blue Cross and Blue Shield of Nebraska is an Equal Opportunity /Affirmative Action Employer - Minorities/Females/Disabled/Veterans

Instant Answers