Credentialing Supervisor

Overview

The Credentialing Supervisor is responsible for providing expertise, support, and guidance to their designated credentialing team executing in the standard operating protocol directed by needs of business operations. Ensure the integrity of credentialing protocol and implementation of protocol is maintained in all aspects of the work by the departmental members. The Supervisor will ensure that work is initiated in a timely manner, and completion of the work is kept at pace for operational success. Effective communication with the Credentialing Director and operations leaders is critical for prioritization and team function. The employee will perform work to process provider applications for privileges, reappointments by targeted start dates, and renewal dates. Oversight into job activities includes the surgical assistants and intraoperative monitoring technologists/technician groups and all workflows associated with those providers.

Responsibilities

Essential Job Duties and Responsibilities

• Understand, refine and implement protocols in all aspects of credentialing workflows.
• Serve as a lead resource to team members within the Surgical Assist credentialing operations.
• Populate and prepare applications for providers.
• Manage, facilitate and report on employee onboarding, initiation of applications, and facility reappointments associated to provider credentialing.
• Perform monthly audits on the team’s completed work and adherence to processes. Provide insightful feedback to team members on a regular basis and ensure completeness to applications.
• Maintain complete and accurate provider credentialing files, according to Joint Commission credentialing standards.
• Monitor and notify providers of upcoming due dates, including expiring privileges, licensures, board certifications, MSO requirements and all other state and national required documents necessary for the practitioner to perform under their scope of practice legally and ethically.
• Supports and leads efforts to improve team cohesion. Address team issues or present to leadership for resolution.
• Maintain and update all credentialing databases as provider information and credentials change, renew or terminate.
• Maintain and update continuing medical education credits and other training requirements.
• Establish and maintain professional working relationships with providers and medical staff service departments.
• Performs weekly general maintenance and management of Salesforce.
• Provide weekly status updates to Director and clinical leaders.
• Demonstrate exemplary customer service to our providers and facilities.
• Meet targeted credentialing deadlines and start dates.
• Adhere to Joint Commission standards for all processes.
• Proficiently use SalesForce, and MD Staff credentialing system as instructed by leadership.
• Contribute to the advancement, maturity, and growth of the department.
• Provides employee training to credentialing new hires, specific to area of Surgical Assists.
• Adhere to the MPOWERHealth’s Employee Handbook.
• Adhere to Credentialing Department policy and procedures.
• Attend weekly management, operations, or leadership develop meetings as needed.

· Perform other duties as assigned.

Qualifications

• High School graduate or equivalent. AS or B.S. degree in business administration or health care related field is a plus.

· Two years of credentialing experience.

Skills/Specialized Knowledge

• Knowledge of organization’s policies, procedures, and systems.
• Working knowledge of credentialing process and requirements.
• Knowledge of NCQA and/or JCAHO Accreditation standards.
• Knowledgeable in Federal and State Regulation on Confidentiality and Peer Review Guidelines.
• Skilled in computer applications Office365, database administration and scanning applications.

· Excellent customer service skills.

• Have strong organizational and time management skills.
• Ability to be flexible to change and growth.
• Ability to work effectively in a fast paced, high-volume environment.

· Ethical problem-solving skills.

• Professional verbal, written, and email communication skills.
• Effective collaboration with staff, clinical providers, and business partners.
• Communicate professionally with the public.
• Independent and consistent execution of job responsibilities.

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