Role Description The Credentialing Coordinator I is responsible for the processing, reviewing, and maintaining provider and facility credentialing and re-credentialing files within department turnaround and quality standards. He/she is responsible for working with the management team to monitor compliance of current workflows, assisting with defining revised workflows, and for distributing the day's assignments in the absence of the manager. - Enters and updates provider and facility data in credentialing database, PEP, and QNXT while still adhering to input standards, including for the OneCare and SCO lines of business. - Works with External Credentialing Verification Organization (CVO) on processing Credentialing Information and Reporting, as well as Delegate Credentialing information. - Maintains required ongoing monitoring and sanctions reporting. - Coordinates the processing of initial and re-credentialing applications within the established turnaround times while ensuring that Mass General Brigham Health Plan meets all State and NCQA requirements through the HCAS (HealthCare Administrative Solution) streamlined credentialing process. - Conducts verification of credentialing elements completed by CVO (i.e., license, DEA, board certification, and NPDB) through the use of system resources, and documents the status in the credentialing database and PEP. - Performs review and analysis of provider and facility credentialing and re-credentialing applications to determine completeness, including notifying providers when their applications are incomplete or missing information. - Provides representation, assistance, and guidance on the credentialing process during committee meetings. - Meets or exceeds all department quality standards for all initial and re-credentialing files. - In the absence of the manager, interacts and responds to inquiries from teammates with specific questions. - Holds self and others accountable to meet commitments. - Persists in accomplishing objectives to consistently achieve results despite any obstacles and setbacks that arise. - Builds strong relationships and infrastructures that designate Mass General Brigham Health Plan as a people-first organization. Qualifications - Education: Associate's Degree preferred - Experience: - At least 1-2 years of experience in Clinical/Medical Office/Healthcare required - At least 2-3 years of previous credentialing experience, with at least 1 year in a health insurance environment, highly preferred - Experience with OneCare and/or SCO highly preferred - Knowledge, Skills, and Abilities: - Knowledge of medical provider credentialing and accreditation principles, policies, processes, procedures, and documentation. - Competence in Microsoft Office including Outlook, Excel, and Word. - Ability to use independent judgment and to manage and impart confidential information. - Skill in establishing priorities with independent coordination of day-to-day aspects. - Ability to communicate effectively both orally and in writing. - Information research skills. - Ability to handle multiple tasks. Requirements - This is a remote role that can be done from most US states. - This is a full-time Eastern Standard schedule (e.g. 8-4:30 pm or 8:30-5:00 pm ET). - Remote workdays require a stable, secure, quiet, and compliant workspace. - Scheduled Weekly Hours: 40 - Employee Type: Regular - Work Shift: Day (United States of America) - Pay Range: $17.71 - $25.28/Hourly - Grade: 2 Benefits - Competitive salaries and a benefits package with flexible work options. - Career growth opportunities. - Recognition programs designed to celebrate your contributions and support your professional growth.

• Responsible for credentialing behavioral health providers (clinicians and facilities) for inclusion in the Lucet provider network • Work collaboratively with providers, external agencies, and other team members within Network Operations and management staff to promote timely processing • Research and verify provider credentials, including licensure, education, insurance coverage, and professional background • Communicate with external agencies and conduct database searches to validate provider qualifications • Review provider applications for errors and inconsistencies; follow up to obtain required information • Maintain accurate provider records in credentialing databases • Prepare and update provider files for presentation to Credentialing Committee meetings • Support departmental projects and identify opportunities to improve workflows

• Responsible for completion of credentialing functions • Ensures program integrity and compliance with standards, federal/state requirements, and health plan credentialing requirements • Maintains relationships with health plan auditors, communicates and works with physician leaders on credentialing issues • Works with other departments in multiple areas that relate to credentialing issues • Audits Credentialing Verification Organization's released files to ensure it obtains primary source verification of required physician information • Maintains database of current and accurate information concerning licensure, board certification, professional liability coverage and claims for physicians, contracted providers and Allied Health Professionals

Role Description This position is responsible for providing coaching, operational, and infrastructure support to an operations team responsible for credentialing and recredentialing of practitioners and facilities who are currently contracted or wish to be contracted with the Company. This position will research and consult on standard and escalated practitioner and facility credentialing matters. Duties - Assist Team in daily responsibilities to meet team performance goals to include inventory monitoring and reporting. - Manage high priority and specialized requests as appropriate. - Reviews, analyzes, and reports on individual, team and department data for trends, gaps, and variances from department performance standards. - Ensure all credentialing processes are in compliance with company policies as well as the National Committee for Quality Assurance (NCQA) standards in an effort to maintain accreditation. - Provides development and coaching to employees on a consistent basis. Feedback is provided in a timely manner and suggestions for improvements are outlined. - Create and maintain internal training materials in collaboration with department management and training teams. - Leads training efforts of new team members. - Leads mentor, audit, and readiness efforts of new team members and those on a performance improvement plan to identify and model best practice. - Assists Department with operational tasks associated with credentialing operations. - Participates in projects that involve the collection of credentialing applications. - Participates in projects, as a subject matter expert that involve system design/re-design related to credentialing operations. - Tests all credentialing operations related system(s) design/re-design related to credentialing operations. - Serve as a subject matter expert for all credentialing activities performed within assigned areas including the education and training of staff extenders on credentialing methodologies and approaches, with an emphasis on operational efficiency and quality optimization. - Utilizes knowledge outside of team's standard procedures to increase contextual understanding of processes. - Ability to compose and present communications describing tasks and overall context, including existing process guidelines as well as associated risks and controls. - Collaborate, coordinate, and communicate across disciplines and departments. - Ensure compliance with HIPAA regulations and requirements. - Demonstrate Company's Core Competencies and values held within. - The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned, as necessary. Qualifications - Minimum High School Diploma or G.E.D. Bachelor's degree in a relevant field preferred. - Minimum 2 years of experience in provider credentialing preferred. - Experience with team member coaching/mentoring or ability to coach/mentor preferred. - Communication (written, verbal, listening), leadership, problem-solving, and organization skills. - Ability to engage staff at all levels to work toward unified goals and objectives. - Ability to prioritize their work and the work of others to meet rigorous productivity goals and standards. - Ability to present and speak publicly. - Ability to use software, hardware and peripherals related to job responsibilities including MS Office Suites, Microsoft Word, and Excel, etc. - Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier, and telephone. Requirements - Compensation: The salary range for this position is $23 to $26 per hour. Specific offers take into account a candidate’s education, experience and skills, as well as the candidate’s work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity. Benefits - Medical, dental and vision coverage with low deductible & copay. - Life insurance. - Short and long-term disability. - Paid Parental Leave. - 401(k) + match. - Employee Stock Purchase Plan. - Generous Paid Time Off – accrued based on years of service. - 10 paid company holidays. - Tuition reimbursement. - Flexible Spending Account. - Employee Assistance Program. - Sick time benefits – for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year, unless the laws of the state in which the employee is located provide for more generous sick time benefits. EEO Statement Claritev is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status. Application Deadline We will generally accept applications for at least 5 calendar days from the posting date or as long as the job remains posted.