Associate Manager of Credentialing

Epic Staffing Group

7d•$55,000 - $65,000

About The Position

The Associate Manager of Credentialing is responsible for the management of the credentialing team, ensuring comprehensive management of privileging and credentialing processes for all providers, licensed clinicians, and ancillary staff. This role is responsible for strategic oversight, compliance management, and leadership in maintaining high standards of credentialing efficiency and accuracy.

Requirements

Three years of experience in education or healthcare staffing credentialing.
Certified Provider Credentialing Specialist (CPCS) can substitute for experience.
Possess an overall knowledge of business functions and understanding of services, business strategy, policies and procedures, and job’s impact to the organization.
Understand, interpret, and ensure compliance with laws and regulations.
Maintain trust through honesty, adherence to principles, and personal accountability.
Obtain facts and data pertaining to an issue or question.
Make quality decisions and meet the timeliness of those decisions.
Share responsibility, authority, and accountability.
Create a motivating climate, achieve teamwork, train, and develop, measure work in progress, and take corrective action.
Engage effectively in dialogue.

Responsibilities

Manage the performance and development of direct reports, providing training, coaching, and conducting regular employee reviews.
Conduct regular performance evaluations, provide constructive feedback, and develop individualized development plans for team members.
Educate departments on credentialing policies, procedures, and internal policy changes as necessary.
Oversee The Joint Commission reviews and quarterly data submissions.
Audit and approve invoices from credentialing vendors for each SBU.
Review and approve background checks and licensing issues, escalating employment determinations when necessary.
Implement robust policies and procedures to ensure accurate verification and uploading of applications into the online credentialing database system.
Analyze application status trends, evaluate verification information, and identify areas of non-compliance or 'red flags'; recommend and execute appropriate corrective actions.
Manage incoming and outgoing communications, ensuring adherence to policy timelines while updating the credentialing database; provide status reports and communicate practitioner participation information to internal and external stakeholders.
Facilitate written and verbal communications with federal, state, and local agencies, hospitals, medical review boards, and malpractice carriers to obtain necessary provider and practitioner information.
Participate in preparation for internal and external audits to ensure accurate provider information and compliance with regulatory/accreditation requirements (e.g., CMS, DSHS, NCQA, JCAHO, DNV).
Assist practitioners and clinicians with scheduling appointments and necessary medical procedures (e.g., physicals, drug screens, vaccinations).
Stay informed about research, review, and interpretation of applicable accreditation, licensing, and regulatory requirements to ensure ongoing compliance of credentialing policies and procedures.