Delegation Manager

MultiCare Health System

3d•Onsite

About The Position

The Manager of Delegated Credentialing is responsible for the operational oversight of all delegation credentialing activities and the coordination of delegation credentialing functions. Acts as a liaison between the provider, staff, hospital/clinic leadership and payors; and facilitates communications between these entities as appropriate. The manager directs and provides operational support for the MAP (MultiCare Ambulatory Provider) Committee, and project management oversight of new MHS affiliates and subsequent provider onboarding. Serves as a subject matter expert and provides insight to the organization as it relates to delegation of credentialing requirements. This position is also responsible managing the credentialing and re-credentialing delegation activities. Assists in compliance with accrediting and regulatory agencies (i.e. JCAHO, NCQA, CMS, and WA State), maintaining a working knowledge of the statutes, laws and standards. Performs pre/sub-delegation credentialing audits for the MHS and CIN networks; preps and participates in the annual delegated health plan audits; performs ongoing monitoring and reporting out on any quality actions taken upon credentialed providers. The manager maintains the confidentiality of all work and delegation credentialing information. Assists in managing the flow of information between the Medical Staff Services team members, MMA Leadership and Administration. Establishes processes to assure the accuracy and integrity of the credentialing database system for delegated providers. Reports to the Executive Medical Staff Services Director to support delegated credentialing activities and special projects for all physicians and health care affiliates within MultiCare Health System hospitals and MultiCare Medical Group and MultiCare Connected Care CIN, under the authority of the Chiefs of Staffs of the Medical Staffs and the MHS Sr. VP-Chief QIMA Officer. Work situations are varied and involve highly confidential information and require a professional demeanor, organizational skills, independence and attention to detail. The manager provides direction and oversight to delegation credentialing staff. Monitors staff compliance with operational policies, seeking staff involvement and collaboration in the development/revision of policies, including the encouragement of on-going process improvement discussions. Hospital-based leaders may have a dual matrixed reporting structure.

Requirements

Minimum of an Associate's degree or equivalent additional relevant experience in lieu of education
Minimum five (5) years Medical Staff Services experience
Credentialing experience in an acute care setting
Experience with delegation oversight assessments/audits
Minimum three (3) years of experience in a supervisory or lead capacity
Data Analysis experience
Previous experience and demonstrated skills in a supervisory or lead capacity
Credentialing database experience preferred
Health Plan Delegation experience strongly preferred

Nice To Haves

Certified Provider Credentialing Specialist (CPCS) by the National Association of Medical Staff Services preferred

Responsibilities

Operational oversight of all delegation credentialing activities
Coordination of delegation credentialing functions
Liaison between provider, staff, hospital/clinic leadership, and payors
Directs and provides operational support for the MAP (MultiCare Ambulatory Provider) Committee
Project management oversight of new MHS affiliates and subsequent provider onboarding
Subject matter expert on delegation of credentialing requirements
Manages credentialing and re-credentialing delegation activities
Assists in compliance with accrediting and regulatory agencies (JCAHO, NCQA, CMS, WA State)
Performs pre/sub-delegation credentialing audits for MHS and CIN networks
Preps and participates in annual delegated health plan audits
Performs ongoing monitoring and reporting of quality actions taken upon credentialed providers
Maintains confidentiality of work and delegation credentialing information
Manages the flow of information between Medical Staff Services team members, MMA Leadership, and Administration
Establishes processes to assure accuracy and integrity of the credentialing database system for delegated providers
Supports delegated credentialing activities and special projects for physicians and health care affiliates within MultiCare Health System hospitals, MultiCare Medical Group, and MultiCare Connected Care CIN
Provides direction and oversight to delegation credentialing staff
Monitors staff compliance with operational policies
Seeks staff involvement and collaboration in policy development/revision
Encourages ongoing process improvement discussions