Credentialing Supervisor
Matrix Providers

Job Info

---

To assist in development, management, and monitoring of the processes and procedures that support the credentialing functions/department.

This is a remote position and will be performed out of the candidates home-based office. Individual must have discipline to work in this environment and needs to be reliable and readily available throughout the workday
Priority Areas

• Assist the Center of Excellence (CoE) Director in general oversight of credentialing staff in the day-to-day management of the overall credentialing process.
• Oversee/Implement warm handoff process by partnering with internal stakeholders to meet established timeframes as established via contractual obligations and to reduce candidate drop out.
• Ensure timeliness and accuracy of the credentialing process via established benchmarks to ensure contract compliance.
• Facilitate communications between departments and applicants throughout credentialing.
• Research complex credentialing issues and serve as a subject matter expert (SME) as needed.
• Oversee completion of credentialing files for government contract employee candidates.
• Recommend effective solutions to complex credentialing issues.
• Effectively handle and delegate multiple tasks to ensure timely deliverables and balanced workloads.
• Coordinate the management of the credentialing tracker and/or associated modules to ensure accurate reporting and benchmark monitoring.
• Assist in coordinating the management of electronic credentialing applications, to ensure distribution, receipt, processing, and timely delivery to treatment facility
• Coordinates the development of location specific library and always ensuring it is up to date.
• Coordinates and delegates the management of the expirable process to ensure all contracted provider licenses and certificates remain current, ensuring appropriate notification prior to expiration
• Monitors and reports turnaround times for processing of credentials applications, with continued focus on delivery of a high-quality product, with the greatest efficiency, based on contractual requirements.
• Develops, recommends, and/or implements changes, revisions, and enhancements as appropriate to current operating environment
• Analyzes credentialing standards and develops criteria to ensure compliance; revises general aspects of credentialing and privileging process as necessary; makes recommendations for and implements changes in policies and procedures
• Prepares for and controls credentialing audits in compliance with delegated credentialing contracts
• Functions as primary credentials contact for all internal and external inquiries; develops and maintains positive internal and external working relationships
• Develops comprehensive system to ensure compliance with The Joint Commission (TJC), National Committee for Quality Assurance (NCQA) and/or other regulatory requirements.

Competencies

• Time Management
• Collaboration and Organizational Skills
• Technical Capacity
• Initiative
• Communication Proficiency Recruiting
• Business Acumen
• Change Agent
• Collaboration Skills
• Communication Proficiency
• Decision Making
• Organizational skills
• Leadership
• Problem Solving/Analysis
• Results Driven
• Mentor-Protg Arrangements
• Skilled in the use of Microsoft Office including Excel, Word and PowerPoint
• Experience with CostPoint/Deltek a plus
• Detail orientation
• Strategic Thinking

Physical Demands

Sedentary work which requires talking, typing and concentration
Hours of Work

Full-Time hours with some flexibility in hours is allowed, but employee must be available during core work hours
Travel Requirements

Little travel expected but may require 1-2 times a year to meet in person.

---