Medical Staff Credentialing Director jobs in Miami, FL

Medical Staff Credentialing Director is responsible for all aspects of the verification process for medical staff incumbents. Provides regulatory oversight and guidance to the credentialing process. Being a Medical Staff Credentialing Director maintains working knowledge and ensures continuing compliance with state, federal, and institutional standards and guidelines. Develops and implements policies and protocols related to medical staff verifications and ensures that the organization and staff are in accordance with organizational and industry standards. Additionally, Medical Staff Credentialing Director analyzes reports on applications and credential status to identify trends and improve the credentialing process. Presents files to the credentialing committee and may act as a liaison to state medical licensure boards regarding the status of license applications. Requires a bachelor's degree. May require Certified Provider Credentialing Specialist (CPCS). Typically reports to senior management. The Medical Staff Credentialing Director typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. To be a Medical Staff Credentialing Director typically requires 3+ years of managerial experience. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. (Copyright 2024 Salary.com)

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Manage services organization credentialing and contracting specialist - Now Hiring
  • Eastern Medical Center Corp
  • Miami, FL FULL_TIME
  • Job Description

     

    • Assists in the identification of service level gaps and works with Manager of Provider Relations and Contract Managers to address recruitment opportunities
    • Works with providers and network operations to ensure provider data submission and accuracy
    • Develop, Assist with delivery of provider education in the following areas related to the contract, specifically with the Waiver provide population
    • Relating to the development and management of a provider network,
    • Work with Population Health Management in scheduling ICT meetings with contracted providers within assigned geographic area
    • Identify gaps in network composition and services to assist the network contracting
    • Understands, develops, tracks, monitors and reports on key program performance metrics, such as utilization, coding, and STARs/quality performance

     

    •  Communicates effectively with physicians and their office staff as well as with internal partners
    • Assures compliance with respective contracts. Researches, analyzes and resolves claims, benefits, issues and authorization inquiries within delegated authority
    • Influences membership growth and retention through the provider offices
    • Monitors provider database of current data relating to provider and physician information
    • Ensures provider directories are accurate
    • Investigates compliance issues, identifies root cause, trains provider office staff on correct procedures, and provides written report of findings and recommendations
    • Meets on a regular basis in person or by telephone with assigned key provider groups to cultivate and strengthen relationships. Documents office visits and provider issues on shared drive log

     

    • Support and implement strategies relating to the development and management of a provider network
    • Provide explanations and information to others on topics within area of expertise
    • Prioritize and organize own work to meet deadlines
    • Investigate non - standard requests and problems, with some assistance from others
    • Involved in identifying and remediating operational short - falls and researching and remediating claims
    • Use pertinent data and facts to identify and solve a range of problems
    • Assists Provider Relations Managers with research to identify new providers for recruitment into Beacon Health Options Provider Network

     

  • 1 Day Ago

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Medical Director
  • CareDx
  • Miami, FL FULL_TIME
  • Medical Director CareDx, Inc. is a leading precision medicine solutions company focused on the discovery, development, and commercialization of clinically differentiated, high-value healthcare solutio...
  • 8 Days Ago

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Medical Director
  • La Luz Mental Health Services, Inc.
  • Miami, FL CONTRACTOR
  • Job Overview: We are seeking a highly skilled and experienced Medical Director to join our team. As the Medical Director, you will be responsible for overseeing all medical operations within our organ...
  • 1 Month Ago

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Medical Director
  • Sanitas
  • Maimi, FL OTHER
  • Job Details Level: Experienced Job Location: Miami Dade - Buena Vista - Maimi, FL Salary Range: $183,651.20 - $275,476.80 Salary Job Category: Providers DescriptionSanitas is a global healthcare organ...
  • 1 Month Ago

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Credentialing Specialist
  • Medrina
  • Miami, FL FULL_TIME
  • Join our growing team in Miami, FL, and be a valuable member supporting national healthcare provider with hundreds of sites across U.S.! The Credentialing Specialist is responsible for credentialing o...
  • 16 Days Ago

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Credentialing specialist
  • BilliMD
  • Miami, FL FULL_TIME
  • Company Description At BilliMD, we specialize in simplifying medical billing and revenue cycle management. Our end-to-end solutions integrate seamlessly with EHR / EMR systems, freeing your staff from...
  • Just Posted

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0 Medical Staff Credentialing Director jobs found in Miami, FL area

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National Accounts Medical Director - Remote - Atlanta, GA
  • Optum
  • Miami, FL
  • Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. ...
  • 4/25/2024 12:00:00 AM

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Medical Director - Emergency Medicine - Baptist (Homestead, FL)
  • Nicklaus Children's Health System
  • Homestead, FL
  • Description Job Summary Works closely with the leadership team to support the NCHS mission to provide amazing patient ca...
  • 4/25/2024 12:00:00 AM

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REMOTE: Medical Director, Utilization Management and Medical Policy
  • Evry Health
  • Miami, FL
  • About the Role Evry Health is hiring a tech-savvy Medical Director to lead medical policy and utilization management. As...
  • 4/24/2024 12:00:00 AM

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National Accounts Medical Director - Remote - Atlanta, GA
  • Optum
  • Miami, FL
  • Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. ...
  • 4/22/2024 12:00:00 AM

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Assistant Medical Director (Broward Addiction Recovery Center)
  • Broward County, FL
  • Fort Lauderdale, FL
  • Salary: $174,770.55 - $278,934.69 Annually Location : Ft. Lauderdale, FL Job Type: Full-Time Job Number: 1412167 Departm...
  • 4/22/2024 12:00:00 AM

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Medical Director Physician
  • Familiar Medical Center
  • Miami, FL
  • Job Description Job Description We are seeking a Medical Director Physician to become a part of our team! You will coord...
  • 4/21/2024 12:00:00 AM

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Medical Director of Heart Failure in Miami, Florida
  • University Of Miami Miller School Of Medicine
  • Miami, FL
  • The University of Miami Health System is initiating a search for a Cardiovascular Medicine (Medical Director of Heart Fa...
  • 4/21/2024 12:00:00 AM

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Psychiatrist/ Medical Director- Broward, Palm Beach, Treasure Coast
  • Henderson Behavioral Health
  • Fort Lauderdale, FL
  • Job Description Job Description Psychiatrist/ Medical Director : Broward, Palm Beach, Treasure Coast Job Description: He...
  • 4/21/2024 12:00:00 AM

Miami, officially the City of Miami, is the cultural, economic and financial center of South Florida. Miami is the seat of Miami-Dade County, the most populous county in Florida. The city covers an area of about 56.6 square miles (147 km2), between the Everglades to the west and Biscayne Bay on the east; with a 2017 estimated population of 463,347, Miami is the sixth most densely populated major city in the United States. The Miami metropolitan area is home to 6.1 million people and the seventh-largest metropolitan area in the nation. Miami's metro area is the second-most populous metropolis i...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Staff Credentialing Director jobs
$154,106 to $200,440
Miami, Florida area prices
were up 2.9% from a year ago

Medical Staff Credentialing Director in Flagstaff, AZ
In response to this request for providers in ‘good standing’, a file quality letter will be displayed with the Name, Appointment Date, Reappointment Date, Department, Specialty, and Staff Status.
December 09, 2019
Medical Staff Credentialing Director in Portsmouth, OH
Warstler, MBA, CPMSM, FASPR, director, University Hospitals Medical Staff Services and Credentialing; Lisa.
February 07, 2020
Medical Staff Credentialing Director in Altus, OK
In healthcare today, we are all challenged to be more efficient, process credentialing files faster, leverage technology to work smarter, stretch our budgetary dollars, and achieve the highest possible results on accreditation audits and surveys—all while improving the patient experience and providing the highest quality of care.
January 17, 2020