Manager, Credentialing

OneOncology

18h•Remote

About The Position

OneOncology is positioning community oncologists to drive the future of cancer care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer. Our team is bringing together leaders to the market place to help drive OneOncology’s mission and vision. Why join us? This is an exciting time to join OneOncology. Our values-driven culture reflects our startup enthusiasm supported by industry leaders in oncology, technology, and finance. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of community oncologists and the patients they serve. Job Description: The Credentialing Manager will report to OneOncology’s Sr. Manager, Credentialing and is responsible for leading the day-to-day activity and workflow of assigned practices and their credentialing team members. The Manager is responsible for the performance of their Credentialing Team with oversight of credentialing, re-credentialing, and privileging processes for health care providers while complying with state and federal standards. Additional responsibilities include maintaining up-to-date data in credentialing databases, electronic systems and hard copy files as well as tracking and managing provider licenses, certifications, and other related documentation.

Requirements

5+ years credentialing/non-delegated enrollment experience required
3+ years Supervisory experience required, preferably in a credentialing/enrollment environment
Current working knowledge/expertise of enrollment processes with Commercial and Government payors is required
Experience leading credentialing and enrollment activities in large provider practice (or multiple practices) is highly preferred
Excellent written and verbal communication skills
Participate in the implementation of credentialing software tools
Strong organizational capabilities and the ability to manage multiple complex projects at the same time
Data aggregation and analysis

Nice To Haves

Bachelor’s degree preferred
Training experience preferred but not required
Certifications preferred but not required
Remote work capability with flexibility for travel as needed

Responsibilities

Lead a team of Credentialing Specialists to ensure timely and accurate processing of hospital applications and payer enrollments for multiple practice locations, proactively resolving delays or issues
Support the Credentialing Team by directly performing enrollment, credentialing, and license application/renewal functions when needed
Prioritize and ensure timely provider onboarding with routine communication regarding progress, delays, and needs
Serve as a leader by supporting administrative tasks such as interviewing candidates, leading education sessions, and offering support to the Credentialing Supervisors and Specialists
As necessary, conduct practice level assessments, document current work process, and develop a gap analysis to OO’s standard practices
Assist credentialing leadership with the design and management of policies and procedures related to the credentialing and enrollment processes, ensuring compliance with all regulatory and accreditation requirements
Support process improvement initiatives streamlining credentialing activities for assigned practices
Assist in the workflow design and implementation of new technology features released by our technology vendors
Serve as a subject matter expert and resource across the OneOncology platform for partner practices and internal departments
Work with leadership to develop standard reporting packages
Build and maintain relationships with external partners and payers and communicate with payers on questions or barriers in information
Coordinate with the Revenue Cycle Management team to triage questions related to licensing, credentialing and enrollment, assist in the resolution of claims denied due to credentialing and enrollment issues, and payor portal management
Other tasks as assigned to drive our mission of improving the lives of everyone living with cancer