Manager Credentialing (PER DIEM)

Cooper University Hospital•Camden, NJ

6d•$41 - $70•Onsite

About The Position

Manage staff that process credentialing and re-credentialing applications for medical providers. Implement policies and procedures to ensure that applications are properly verified and accurately uploaded into an online credentialing database system. Ensures compliance with the appropriate accrediting and regulatory agencies. The Manager is integral to Cooper University Health Care maintaining The Joint Commission and Managed Care Delegated Credentialing Contracts. Facilitates, administers, and maintains quality controls on all aspects of the privileging and credentialing processes of initial and reappointment applications to the medical staff. Assigns applications to Credentials Specialists. Based on volume, may process initial and reappointment applications. Monitors and reports turnaround times for processing credentialing applications with continued focus on delivery of a high quality product, with the greatest efficiency, in the lease amount of time. Serves as Credentialing Database Administrator. Coordinates the management of the credentialing database and associated modules, ensuring accuracy of data and reporting to downstream systems. Monitors critical data for extensive analysis and report generation. Set and maintain database standards. Develop processes for optimizing database security; manage database access. Create and manage database reports, visualizations and dashboards. Directs, supervises and evaluates work activities of Credentials Specialists, which includes work allocation, training, enforcement of internal procedures and controls, and problem resolution. Evaluates performance and makes recommendations for personnel actions, motivates employees to achieve peak productivity and performance. Manages Credentials Committee meetings including agenda and packet preparation, minutes and appropriate follow-up – specific to credentialing activities (initial applications, reappointments, increase in privileges, and confirmation of appointment). Serves as liaison between Credentials Committee and Medical Staff Services office. Analyzes and recommends changes in credentialing processes and functions to assure ongoing compliance with TJC, CMS, NCQA, delegated credentialing agreements and other regulatory bodies. Ensures processes are coordinated, timely, accurately and in compliance with regulatory requirements including TJC, NCQA and URAC accreditation standards. Authorized to approve supply orders up to $500.00. Participates in the development of the department budget advising Department Director of new fees associated with credentialing as well as other needs of adjustments required to operate productively, efficiently and in a cost effective manner.

Requirements

3-5 years credentialing experience.
Bachelor’s Degree

Nice To Haves

Certified Provider Credentialing Specialist or Certified Professional Medical Services Management Preferred
Achieve either certification within 7 years of hire.

Responsibilities

Manage staff that process credentialing and re-credentialing applications for medical providers.
Implement policies and procedures to ensure that applications are properly verified and accurately uploaded into an online credentialing database system.
Ensures compliance with the appropriate accrediting and regulatory agencies.
Facilitates, administers, and maintains quality controls on all aspects of the privileging and credentialing processes of initial and reappointment applications to the medical staff.
Assigns applications to Credentials Specialists.
Monitors and reports turnaround times for processing credentialing applications with continued focus on delivery of a high quality product, with the greatest efficiency, in the lease amount of time.
Serves as Credentialing Database Administrator.
Coordinates the management of the credentialing database and associated modules, ensuring accuracy of data and reporting to downstream systems.
Monitors critical data for extensive analysis and report generation.
Set and maintain database standards.
Develop processes for optimizing database security; manage database access.
Create and manage database reports, visualizations and dashboards.
Directs, supervises and evaluates work activities of Credentials Specialists, which includes work allocation, training, enforcement of internal procedures and controls, and problem resolution.
Evaluates performance and makes recommendations for personnel actions, motivates employees to achieve peak productivity and performance.
Manages Credentials Committee meetings including agenda and packet preparation, minutes and appropriate follow-up – specific to credentialing activities (initial applications, reappointments, increase in privileges, and confirmation of appointment).
Serves as liaison between Credentials Committee and Medical Staff Services office.
Analyzes and recommends changes in credentialing processes and functions to assure ongoing compliance with TJC, CMS, NCQA, delegated credentialing agreements and other regulatory bodies.
Ensures processes are coordinated, timely, accurately and in compliance with regulatory requirements including TJC, NCQA and URAC accreditation standards.
Authorized to approve supply orders up to $500.00.
Participates in the development of the department budget advising Department Director of new fees associated with credentialing as well as other needs of adjustments required to operate productively, efficiently and in a cost effective manner.