Flex The PNO Operations Supervisor is accountable for supervising all aspects of the combined enrollment and credentialing department in the Provider Network Operations (PNO) Division for Arkansas Blue Cross Blue Shield, USAble Corporation, and Health Advantage. The incumbent is responsible for ensuring that all credentialing processes and procedures are completed in accordance with established regulatory and policy guidelines as well as the gathering and maintenance of provider demographic, reimbursement and practice information, and maintaining this information timely and accurately in the Enterprise provider systems. These processes are critical to support the payment of claims, network development, provider directory publication, public access to online directories, and IRS reporting. The incumbent has the authority to make decisions in day to day operations to include provider enrollment, credentialing, and contracting activities and is accountable for effectively analyzing, developing, and implementing workable solutions to network problems and/or changes in network strategies. Analytical, Conflict Resolution, Critical Thinking, Interpersonal skills, Leadership, Oral Communication, Problem Solving, Task Delegation, Time Management, Written Communication Accountable for the gathering and maintenance of provider demographic, reimbursement and practice information, and maintaining this information accurately in the Enterprise provider databases., Attends the monthly EEC meeting and facilitates proceedings, as appropriate, in the Provider Network Administrator’s absence., Coordinates and researches issues/complaints from internal and external customers., Develops, implements, and maintains processes for the credentialing and recredentialing of providers and ensures that minimum quality standards are met and completed in accordance with relevant state and federal regulations and policies., Develops, implements, and maintains processes for the organization, scanning and retrieval of provider records., Develops and maintains processes for reporting and analyzing provider data for use in network management, claims payment, provider directory publication, IRS reporting, group account sales, and other ad hoc needs. Responsible for timely submission of all such required records or reports., Functions as PNO Manager, as appropriate, in the PNO Manager’s absence., Interprets complex computer system documentation, as well as state and federal regulatory guidelines, and translates these into operational processes., Interprets provider contract terms and reimbursement rules, and ensures the provider databases are set up to apply them correctly., Participates in the development of provider education programs and provider communication tools, including newsletters, office manuals, and provider correspondence., Performs objective evaluations of quality, quantity, and timeliness of services provided to both internal and external customers., Responsible for coordinating the development and maintenance of the forms, policies, and procedures utilized as part of the provider enrollment and credentialing processes, including the on-going maintenance and modification of these items., Responsible for initiating and maintaining good relations with providers and their staff, PHOs, hospitals, joint venture partners, state agencies and other company personnel in order to maintain and improve provider satisfaction., Serves as a primary contact to providers and to all areas of the Enterprise on all matters relating to provider information, and works closely with the Regional Offices and Network Development Reps in the support of provider network management., Supervises the hiring, coaching/training, employee development and performance management of assigned team. Regular