Sr. Credentialing Manager

CHG Healthcare   •  

Fort Lauderdale, FL

Industry: Patient Care

  •  

5 - 7 years

Posted 294 days ago

This job is no longer available.

This position is directly responsible for ensuring efficient operation of the External Credentialing Department within Medical Staff Services in accordance with CHG Healthcare, applicable standards, corporate policies and procedures, mission, core values and department expectations. This position is responsible for covering for the Medical Staff Services Sr. Director to support other departments as needed.

How You'll Contribute

  • Assist in all aspects of the investigation and management of provider credentialing, privileging, and assignment related processes to ensure compliance of company credentialing standards
  • Research questions and problems regarding federal/state regulations and health care standards
  • Participates in ongoing monitoring and competency evaluation of our providers
  • Participates in hiring, training, development, and retention of the medical staff services team
  • Conducts regularly scheduled one-on-one/side by side meetings with direct reports, designed to enhance awareness, support, and accountability
  • Maintain a “score board” for the external credentialing that recognizes an ethical, performance and quality based work environment
  • Responsible for the administration and tracking of the external credentialing team’s monthly bonus plan
  • Contribute to ongoing process improvement
  • Contribute to a positive culture
  • Focus on near term vs. long term priorities
  • Participates in regularly scheduled meetings with each sales team to review provider files that are in process and/or scheduled to work to discuss credentialing status; alerting them of any concerns that may impact the file completion or start date
  • While partnering with Medical Staff Services Sr. Director, create, implement, and measure an operating strategy for the external credentialing team that maximizes efficiency, builds awareness, and ensures timeliness
  • Responsible for communicating the key aspects of external credentialing processes to MSS Sr. Director and other leaders within the organization
  • Other duties as assigned by management
  • When other Medical Staff Services Manager is out, work with team lead to cover business needs of the Medical Staff Services team
  • Takes strong initiative in staying up to date with federal/state regulations and health care standards, and educate leadership team and department, while ensuring processes adhere
  • Providing formal presentations to the company and departments as needed
  • Participate in mentoring Medical Staff Services leaders in order to contribute to the further development of the leadership team
  • Serve as a point of contact for Sr. Director to support other departments as needed 
  • Master aspects of other businesses within Medical Staff Services
    Participate in management meetings and provide feedback and suggestions to solve team, department, and divisional issues
  • Participate in the creation of the team’s monthly business review and annual business plan
  • Contribute innovative ideas and strategies for the team and division, and keeps the team focused on key initiatives and priorities
  • Identify team opportunities and demonstrate the ability to positively impact results in team engagement, quality and retention

What You'll Bring

  • Excellent written and verbal communication skills
  • Strong organizational skills
  • Excellent customer service and problem solving skills
  • Accurately type 35 wpm
  • Experience with MS Word, Excel and/or database applications
  • Excellent follow-up and follow through skills
  • Work effectively with other managers towards accomplishing business plan goals
  • Strong interpersonal skills
  • College level education, preferably in health care related field
  • A CPCS certification is preferred but not required
  • Minimum of five years quality improvement and/or health care related, risk management/claims management experience
  • Minimum of two years’ experience drafting written correspondence to professionals such as physicians, attorneys and/or large clients
  • Minimum of three years’ experience in a leadership position, successfully leading a multi -level leadership team containing manager level and supervisor level leaders
  • Efficiently manage large amounts of information and documentation
  • Integrate individual efforts for team objectives and goals
  • Persuade, influence, and educate co-workers, health care providers and clients in a positive, professional manner, in order achieve desired results
  • Work independently and with little supervision
  • Prioritize and manage multiple tasks and responsibilities efficiently, while exercising strong delegation skills.
    Follow direction of Department Sr. Director, and Sr. Management personnel
  • Good problem-solving abilities

Preferred Skills:

 

  • Minimum of  two years’ experience with medical service billing (i.e., Medicare/Medicaid)
  • Minimum of two years’ experience researching government regulations, health care standards, and other issues related to quality improvement/risk management
  • Minimum of two year hands-on clinical experience

What We Offer

  • Competitive base salary + bonus
  • Comprehensive training - we are Hall of Fame members among the world’s top training organizations
  • Medical, dental, vision, and 401(k) matching
  • Generous paid time off and holidays
  • Retirement planning and savings options
  • Tuition assistance
  • On-site health center
  • On-site gym
  • Ability to make an impact in the communities we serve

To learn more about our company and culture, visit us here

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