To assist in development, management, and monitoring of the processes and procedures that support the credentialing functions/department.
This is a remote position and will be performed out of the candidates home-based office. Individual must have discipline to work in this environment and needs to be reliable and readily available throughout the workday Priority Areas
Assist the Center of Excellence (CoE) Director in general oversight of credentialing staff in the day-to-day management of the overall credentialing process.
Oversee/Implement warm handoff process by partnering with internal stakeholders to meet established timeframes as established via contractual obligations and to reduce candidate drop out.
Ensure timeliness and accuracy of the credentialing process via established benchmarks to ensure contract compliance.
Facilitate communications between departments and applicants throughout credentialing.
Research complex credentialing issues and serve as a subject matter expert (SME) as needed.
Oversee completion of credentialing files for government contract employee candidates.
Recommend effective solutions to complex credentialing issues.
Effectively handle and delegate multiple tasks to ensure timely deliverables and balanced workloads.
Coordinate the management of the credentialing tracker and/or associated modules to ensure accurate reporting and benchmark monitoring.
Assist in coordinating the management of electronic credentialing applications, to ensure distribution, receipt, processing, and timely delivery to treatment facility
Coordinates the development of location specific library and always ensuring it is up to date.
Coordinates and delegates the management of the expirable process to ensure all contracted provider licenses and certificates remain current, ensuring appropriate notification prior to expiration
Monitors and reports turnaround times for processing of credentials applications, with continued focus on delivery of a high-quality product, with the greatest efficiency, based on contractual requirements.
Develops, recommends, and/or implements changes, revisions, and enhancements as appropriate to current operating environment
Analyzes credentialing standards and develops criteria to ensure compliance; revises general aspects of credentialing and privileging process as necessary; makes recommendations for and implements changes in policies and procedures
Prepares for and controls credentialing audits in compliance with delegated credentialing contracts
Functions as primary credentials contact for all internal and external inquiries; develops and maintains positive internal and external working relationships
Develops comprehensive system to ensure compliance with The Joint Commission (TJC), National Committee for Quality Assurance (NCQA) and/or other regulatory requirements.
Competencies
Time Management
Collaboration and Organizational Skills
Technical Capacity
Initiative
Communication Proficiency Recruiting
Business Acumen
Change Agent
Collaboration Skills
Communication Proficiency
Decision Making
Organizational skills
Leadership
Problem Solving/Analysis
Results Driven
Mentor-Protg Arrangements
Skilled in the use of Microsoft Office including Excel, Word and PowerPoint
Experience with CostPoint/Deltek a plus
Detail orientation
Strategic Thinking
Physical Demands
Sedentary work which requires talking, typing and concentration Hours of Work
Full-Time hours with some flexibility in hours is allowed, but employee must be available during core work hours Travel Requirements
Little travel expected but may require 1-2 times a year to meet in person.
