Supervisor Credentialing

JOB SUMMARY :

Responsible for supervising credentialing personnel and oversight of training. Supervise workflows and projects to support timely, efficient production. Responsible for ensuring credentialing policies and procedures are compliant with regulatory agencies and accreditation standards.

KEY RESPONSIBILITIES :

• Provide day-to-day supervision of personnel. Evaluate performance of direct reports and provide regular feedback individually and to the team. Identify improvement opportunities to support continuous development. Assists in the maintenance of MD Staff Software to ensure quality provider data. Responsible for updating policies and procedures with regard to all credentialing and provider data processes.
• Assists in coordinating the agenda, reporting and follow-up of activities related to the Credentials Committee. Responsible for ongoing sanctions review of all providers through internal monitoring activities. Coordinate, assist in, and follow up of the weekly audit of credentialing files.
• Responsible for supervision, including monitoring and assessing reports, to ensure providers are credentialed in accordance with state mandates, and policy and procedures. Responsible for oversight of initial processes, reappointment processes, and CAQH utilization.
• Report on credentialing activities and performance to the appropriate internal committees. Responsible for interdepartmental communication to provide and receive assistance regarding credentialing applications for both initial and reappointment applications. Responsible for processing credentialing related invoices and statement, including Credentials Committee Stipends, for appropriate approvals and submission to Accounts Payable.
• Assists in the Delegated Credentialing Oversight activities.
• Perform other duties as assigned.

QUALIFICATIONS :

EDUCATION / EXPERIENCE :