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Credentialing Associate Director
Credentialing Associate DirectorErie Family Health Centers • Bensenville, IL, United States
Credentialing Associate Director

Credentialing Associate Director

Erie Family Health Centers • Bensenville, IL, United States
1 day ago
Job type
  • Full-time
Job description

Join our dedicated team! Motivated by the belief that healthcare is a human right, we provide high-quality, affordable care to support healthier people, families, and communities. We deliver holistic care to help every family member stay healthy and active from infancy through adulthood. Since our inception, we have consistently offered high-quality care to diverse patients most in need, regardless of their insurance status, immigration status, or ability to pay.

We are currently seeking a valuable addition to our Credentialing team as a Credentialing Associate Director. In this role, you will support the Director of Credentialing by overseeing initial credentialing, recredentialing, privileging, and ongoing monitoring of credentials and regulatory requirements for all licensed and credentialed providers and employees. You will respond to regulatory changes and assist in strategic directions to ensure operational efficiency and compliance. This includes developing tools, techniques, and evaluation protocols to oversee and improve a centralized process, maintaining high standards for compliance.

We offer competitive salaries, high-quality health care plans, generous time off benefits, retirement benefits, and more! Our Comprehensive Benefits Package includes Medical, Dental, Vision, Life and Disability Insurance, and Flexible Spending (FSA) options. We also provide a 401(k) program with matching, starting at 20 days of PTO, and 8 paid holidays. Competitive salaries, annual merit increases, and opportunities for growth and career advancement are all part of working with us!

  • Compensation is based on each candidate's experience, skills, and education within the identified range for the role. Candidates meeting the minimum requirements will start at the entry level in the range, with additional skills and experiences reflected in the offered compensation.

Main Duties & Responsibilities :

  • Collaborate with the Director of Credentialing to develop and implement policies and protocols to verify and ensure that licensed independent practitioners and clinical staff are processed according to industry standards.
  • Supervise, train, and coach Credentialing Specialists to ensure departmental performance outcomes.
  • Oversee all aspects of credentialing processes, ensuring compliance with standards, bylaws, state and federal requirements, accreditation standards, and payer enrollments.
  • Manage disclosures of claims history and disciplinary actions, working closely with the Director of Credentialing and other leadership.
  • Maintain awareness of current and changing regulatory requirements and assist in updating policies and communicating changes.

    • Education

    Required :

  • High School diploma or equivalent is required.
  • Current NAMSS Certification as Certified Professional Medical Services Management (CPMSM) or Certified Professional Credentialing Specialist (CPCS).

    • Preferred :

  • Undergraduate or graduate degree in healthcare or business management.
  • Dual certification is a plus (both CPMSM and CPCS).

    • Experience

    Required :

  • A minimum of ten (10) years of experience managing full healthcare credentialing processes.

    • Preferred :

  • Five (5) or more years of experience in a Central Verification Office.
  • Knowledge of NCQA credentialing standards.

    • Skills and Knowledge

    Required :

  • Proven experience with credentialing and privileging processes.
  • Comprehensive knowledge of accrediting and regulatory standards.
  • Ability to communicate effectively and professionally in speech and writing.
  • Ability to manage teams and workflows.
  • Excellent analytical and problem-solving skills, along with strong organization and planning abilities.

    • Preferred :

  • Working knowledge of credential verification offices and databases.
  • Knowledge of National Practitioner Data Bank interface and reporting.

    • The Erie Advantage Pledge :

    Our commitment ensures that all current and future employees can feel confident that :

  • Our mission, vision, and values unite us.
  • Our voices matter.
  • We do things well.
  • Our inclusive culture promotes balance and belonging.
  • We find our career sweet spot together.
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    Director Credentialing • Bensenville, IL, United States