Tenet Healthcare Corporation

Director, Credentialing - Onsite in Dallas, TX

Tenet Healthcare Corporation • $110K — $130K *
Dallas, TX 75217In-Person
Healthcare
8 - 10 years of experience
Today
Be an Early Applicant
Job Overview by Ladders

Qualifications

  • Bachelor's degree with equivalent work history, MBA preferred
  • 10 years' experience in service operations
  • 5 years supervisory experience with management skills
  • Excellent written and oral communication abilities
  • Proficient in Microsoft Word and Excel
  • Strong time management and organizational skills
  • Familiarity with HIPAA, Joint Commission, NCQA, and CMS standards

Responsibilities

  • Define national payor credentialing strategy and align with market leaders
  • Direct team priorities to ensure timely provider billing and collection
  • Collaborate with onboarding team for project management changes
  • Address patient access issues related to payor corrections
  • Achieve NCQA Accreditation for delegated strategy rollout
  • Maintain and develop relationships with managed care entities
  • Resolve claims issues linked to credentialing within billing platforms
  • Oversee credentialing department operations and staff management

Benefits

  • Opportunity to work in a growing credentialing network across the US and Philippines
  • Engage with a variety of internal departments including legal and compliance
  • Minimal travel requirements for the role
  • Focus on process improvement and collaboration with health plans
  • Leadership role overseeing a dedicated credentialing team
Full Job Description
Job Description

The Credentialing Director will work with internal experts in provider credentialing and service operations to continue building a US and Philippines-based credentialing network for Tenet and United Surgical Partners International. In addition to overseeing the overall operations and supervision of the credentialing departments, he or she will interface with our colleagues in legal, revenue cycle, compliance, regulatory accreditation, and managed care. Responsibilities will include oversight and efficient usage of all credentialing systems and databases, creation, and submission of all credentialing applications for the physicians and allied health professions both on paper and on-line applications with CAQH, creating and maintaining delegated credentialing agreements, performing root cause denial analysis, and make accounts receivable write-off recommendations.

Responsibilities

  • Defines payor credentialing strategy nationally
    • Work with market leaders nationally to understand manpower plan in each market and define payor credentialing efforts accordingly. This activity includes reviewing pre-onboard data to ensure the payors align with the Tenet agreements and 100% of volume remains intact post-onboard.
    • Direct and prioritize team efforts to ensure providers can bill and collect by the providers defined start date.
    • Work with the onboarding team closely to manage changes with each project.
    • Drive the data to all practices to ensure patient management on the front-end aligns with our agreements.
    • Resolve patient access issues pending payor corrections/load/credentialing to ensure patients are not impacted due to administrative challenges.
    • Achieve and maintain NCQA Accreditation so delegated strategy can be rolled out to all payors.
  • Managed Care liaison
    • Build and navigate sensitive payor relationships outside of managed care to resolve major issues within TPR. This includes all payors with which Tenet has agreements
    • Communicate super-specialist providers onboarding to ensure the enhanced rates are tied to this portfolio by health plan.
    • Collaborate with managed care to resolve loading issues and claims not paid per contract.
    • Maintain and further develop delegated credentialing agreements
    • Challenge payor agenda to drive process improvement on the front and back-end - including delegation.
    • Resource for contract language interpretation.
    • Manage IPA relationships.
  • Revenue Cycle - Credentialing
    • Resolve claims issues that flow to the credentialing worklist within the billing platform in all markets.
    • Assist with denial management for all payors including CMS (Medicare/Medicaid).
    • Responsible for creating billing scenarios in the billing platform that mirror the credentialing structure for all payors.
    • Root cause resolution for internal challenges that causes denials (file maintenance, RCM, Athena partners)
    • Make adjustment recommendations on aged and deemed uncollectable A/R.
  • Communicate with our health plan contacts on a routine basis to ensure ongoing and accurate participation status for our employed physicians at all sites in which the physician is rendering services. This includes initial credentialing/re-credentialing and requests for additional sites.
  • Maintain internal credentialing database and excel spreadsheets on a routine basis.
  • Create and monitor Productivity Standard Reports to ensure staff are meeting the standards set for the department.
  • Oversee the overall operations and supervision of the Credentialing Department, this includes routine credentialing activity and management of department staff.
    • Includes employee selection, evaluation, disciplinary action, and terminations; development/revision of credentialing policies and procedures, credentialing job descriptions and required in-service education.
  • Minimal travel. Selected candidate will be required to pass a Motor Vehicle Records check.


Qualifications

Education: Bachelor's degree and/or equivalent work history required. MBA preferred.

Experience:
  • Ten years of experience in a service operations managing proximate and distal workforce.
  • Five years supervisory experience with excellent management skills.
  • Must be able to work in a team-oriented environment.
  • Excellent written and oral communication skills.
  • Working knowledge of Microsoft Word and Excel.
  • Excellent time management and organizational skills.
  • Proficiency in all applicable software / databases utilized.
  • Understanding of HIPAA, Joint Commission, NCQA, CMS standards and patient confidentiality regulations.
  • Working knowledge of automating tools, including RPA, ML, and AI.

About Tenet Healthcare Corporation

Tenet Fintech Group is an innovative Fintech service provider to the Chinese commercial lending sector.

Tenet Healthcare Corporation Careers

Join the dedicated team at Tenet Healthcare Corporation, a national leader in healthcare services. At Tenet, we are committed to providing the highest quality care and outstanding patient experiences. This commitment extends to our team members in every role across our network.

Work You’ll Do

At Tenet Healthcare Corporation, you will be part of a dynamic team that is passionate about transforming healthcare. Our professionals enjoy a collaborative environment where innovative ideas and a proactive approach to healthcare are at the forefront of what we do.

Explore Job Opportunities and Growth

We offer a variety of job opportunities across clinical, administrative, and corporate disciplines. Whether you are a seasoned professional or just starting your career, Tenet provides a path for growth and development. Our leadership is committed to nurturing talents through advanced training programs, leadership workshops, and continuous professional development.

Innovate and Lead

Join us and contribute to a culture of innovation and continuous improvement. At Tenet, every team member is empowered to make a difference. With access to cutting-edge technology and a network of professionals, you will have the tools to drive real change in healthcare delivery.

Diversity and Inclusion

At Tenet Healthcare Corporation, we celebrate diversity and are committed to creating an inclusive environment for all employees. Our diversity training ensures that our team is respectful, inclusive, and equipped to support the diverse communities we serve.

Internship Programs

Kickstart your career with Tenet’s internship programs. These opportunities allow you to gain hands-on experience while working alongside seasoned professionals. Internships are a great way to develop skills, enhance your resume, and build a network within the healthcare industry.

Benefits and Culture

Our employees enjoy a range of benefits designed to support their physical, financial, and emotional well-being. Join a company that values work-life balance, provides competitive healthcare benefits, and supports your personal and professional growth.

Join Our Team

Are you ready to advance your career in a vibrant healthcare environment? Explore the positions available at Tenet Healthcare Corporation and find where your skills and passion can make a difference. We are actively hiring and looking for individuals who are curious, creative, and eager to drive innovation in healthcare.

Stay Connected

Keep up to date with the latest at Tenet by following our careers blog. Gain insights from our team, learn about our culture, and get tips for your job search and career development.

Networking and Professional Development

At Tenet, networking and professional development are part of our ethos. We encourage our employees to connect, share, and grow together. Enhance your career through comprehensive training, mentorship, and collaboration across our extensive healthcare network.

Apply Now

Discover the rewarding career opportunities at Tenet Healthcare Corporation. Personalize your job search and apply for positions that match your qualifications and interests. Join us in our mission to provide quality care and make a positive impact in the lives of our patients and communities.

SEARCH TENET HEALTHCARE JOBS

Embark on a fulfilling career journey at Tenet Healthcare Corporation, where your growth is our priority, and your potential is limitless.
Learn more about Tenet Healthcare Corporation
Size
76,836 employees
Market Cap
$5.1 billion
Industry
Healthcare
Net Income
$399 million
Founded
1967
5 Year Trend
-0.1%
Revenue
$17.6 billion
NASDAQ
THC
* Ladders Estimates

Similar Jobs

Ad banner background

Get Ready For Your
Next Interview

More Jobs at Tenet Healthcare Corporation

More Healthcare Jobs

Find similar Director, Credentialing - Onsite in Dallas, TX jobs:

NationwideDallas, TX