In this role as Provider Compliance and Policy Manager, you will manage and coordinate audits on behalf of the Provider Credentialing department. Review and provide complete and accurate documentation and results to auditors and government/regulatory agencies as requested, consult on potential issues, and formulate Wellmark’s response. Support timely completion of any recommended actions. Interpret state and federal regulations as well as Blue Cross Blue Shield Association (BCBSA) changes and provide impact to stakeholders regarding changes which may impact Provider Credentialing. Support the management, coordination, and completion of Credentialing regulatory changes and projects. Collaborate and work closely with Legal, Compliance, and Government Relations in the interpretation of regulations in support of business-specific planning and execution. Complete the annual update of department policies and procedures and own the creation of policies/procedures in PolicyTech.
