Quality Compliance Manager
Montefiore Health System•Clarksville, TN
•$60,800 - $76,000•Onsite
About The Position
The Quality Compliance Manager oversees the Quality Compliance program related to the credentialing and privileging process of the Medical and Allied health Staff for all entities in the Montefiore Health System ensuring consistency, accuracy and compliance with established protocols, accreditation and regulatory agencies. Oversees all Regulatory and delegated health plan surveys and audits for all entities of the Montefiore Health System including The Joint Commission, CMS, DOH, NCQA and all delegated health plan requirements.
Requirements
- Bachelor's Degree required
- 5 years of experience
- Experience in an Academic Medical Center, Multi-entity health system.
- Experience in Medical Staff Credentialing and Privileging and payor enrollment Credentialing
- Strong understanding of state, federal and accreditation standards (i.e NCQA, TJC, CMS) related to credentialing and enrollment
- Proficiency in credentialing specific software and systems.
Nice To Haves
- NAMSS certified provider credentialing specialist (CPCS) preferred
Responsibilities
- Oversees the Quality Compliance program related to the credentialing and privileging process of the Medical and Allied health Staff for all entities in the Montefiore Health System ensuring consistency, accuracy and compliance with established protocols, accreditation and regulatory agencies.
- Oversees all Regulatory and delegated health plan surveys and audits for all entities of the Montefiore Health System including The Joint Commission, CMS, DOH, NCQA and all delegated health plan requirements.
Benefits
- An assortment of insurance products and discount programs through Voluntary Benefits.
- Comprehensive benefits available to you when you join our outstanding team!
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What This Job Offers
Job Type
Full-time
Career Level
Manager
