Manager, Credentialing

University of Rochester • New York, NY

122d • $70,197 - $105,295

About The Position

The University of Rochester is seeking a qualified individual to oversee departmental activities related to the credentialing, privileging, and primary source verification process for medical and allied health professionals. This position is crucial in ensuring quality and compliance with regulatory standards while fostering a collaborative environment to enhance practitioner quality and patient safety. The role involves supervising staff, managing departmental processes, and representing the Medical Staff Services Department in various initiatives.

Requirements

• Bachelor's degree in business or healthcare related field.
• 5 years of experience in Medical Staff credentialing and/or payer enrollment functions.
• Previous experience with Joint Commission, CMS, and NCQA Regulations related to medical staff services.
• Previous management experience preferred.

Nice To Haves

• CPMSM - Certified Professional Medical Services Management upon hire preferred.
• Certified Provider Credentialing Specialist (CPCS) upon hire preferred.
• Excellent interpersonal and communication skills.
• Demonstrated success in leading through change.

Responsibilities

• Oversees departmental activities to ensure quality in conducting, maintaining, and communicating the medical and allied health professional staff credentialing, privileging, and primary source verification process.
• Serves as a leading resource of the department and collaborates with others to advance the quality of practitioners and patient safety.
• Supervises ongoing compliance monitoring.
• Recruits, hires, supervises, and manages the performance of department staff members.
• Ensures timely and accurate completion of health care professionals’ credentialing and re-credentialing applications.
• Collaborates with physicians and allied health practitioner leaders to develop and maintain a specialty specific clinical privileging system.
• Ensures compliance with regulatory standards including The Joint Commission, CMS, NCQA, and others.
• Represents Medical Staff Office and Credentials Verification Organization for regulatory audits.
• Develops and maintains credentialing policies to ensure compliance with regulatory standards.
• Provides education to staff regarding medical staff bylaws and credentialing policies.
• Manages the Credentials Privilege Review, Committee and Board Approval Process.
• Develops and implements tools and policies to support knowledge management and communication.
• Coordinates and oversees Proxy Credentialing functions associated with URMC’s contracted Telehealth services.
• Assists the Director with fiscal management and administrative activities for the department.

Benefits

• Health insurance
• 401k
• Paid holidays
• Flexible scheduling
• Professional development opportunities

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Bachelor's degree
• Number of Employees: 1-10 employees