Medical Staff Credentialing Director jobs in Tacoma, WA

About Sound: 

Headquartered in Tacoma, WA, Sound Physicians is a physician-founded and led, national, multi-specialty medical group made up of more than 1,000 business colleagues and 4,000 physicians, APPs, CRNAs, and nurses practicing in 400-plus hospitals across 45 states. Founded in 2001, and with specialties in emergency and hospital medicine, critical care, anesthesia, and telemedicine, Sound has a reputation for innovating and leading through an ever-changing healthcare landscape — with patients at the center of the universe. 

Sound Physicians offers a competitive benefits package inclusive of the items below, and more: 

• Medical insurance, Dental insurance, and Vision insurance 
• Health care and dependent care flexible spending account 
• 401(k) retirement savings plan with a company match 
• Self-managed PTO Plan 
• Ten company-paid holidays per year 

About the Role: 

As the Senior Director of Payer Enrollment and Credentialing, you will play a pivotal role in overseeing the strategic direction and operational execution of payer enrollment and credentialing activities within our organization. Reporting directly to the Chief Revenue Officer (CRO), you will be responsible for developing and implementing comprehensive strategies to ensure timely and accurate enrollment of providers, and maintain compliance with regulatory requirements.  This position is responsible for developing an internal payer enrollment checklist, processes, and assigning responsibilities for tracking the progress for all Sound providers.  This role will also ensure the team lends support to applicants as appropriate; Establish timeline targets and monitor progress of payer credentialing.  Serving as a key member of the revenue cycle leadership team, this role will be responsible for actively contributing valued insights to stakeholders and strive for continuous process improvement. This position provides a proactive interface between leadership and operations - integral to company’s revenue cycle.

The individual is the linchpin for initiating all revenue for Sound Physicians achieving successful delivery of enrollment activities, including regulatory requirements according to time, quality/scope and budget constraints.

The Details:  This opportunity will require some travel (2-5 trips per year).

In this role, you will be responsible for: 

• Developing and executing strategic plans for payer enrollment and credentialing in alignment with organizational goals and objectives
• Providing leadership and guidance to the payer enrollment and credentialing team, fostering a culture of excellence, collaboration, and continuous improvement
• Overseeing the end-to-end payer enrollment process, including initial applications, revalidations, and updates, to ensure timely and accurate enrollment of all providers
• Implementing and maintaining credentialing processes and standards in compliance with regulatory requirements, accreditation standards, and organizational policies
• Implementing new, as well as optimizing existing, tools, processes, systems, and products that streamline the Payer Enrollment team’s work and increase their efficiency/accuracy (i.e standardized playbooks, communication templates, training materials, resource guides, automation features, advanced tooling, etc.) 
• Understanding the clinician life cycle of employment from Hire Date including both obtaining hospital privileges and payer enrollment
• Leading the tracking and measurement of team OKRs as it relates to performance, capacity, margin, and growth targets
• Developing an effective reporting infrastructure with regular monitoring, accommodating ad hoc requests, and analyzing quality and production outcomes for associates, implementing corrective action plans as necessary
• Maintaining master roster of Sound TINs/locations and working closely with stakeholders to strategically select new business TINs in accordance with Sound’s strategic initiatives
• Actively engaging and collaborating with third party billing vendor(s) to ensure timely filing of claims
• Ensuring management team is accurately monitoring performance through coaching, feedback, documentation and disciplinary actions in collaboration with Human Resources
• Managing the department in accordance with budget, identifying variances and making recommendations to address
• Managing the product and system implementation in accordance with the business requirements and User Acceptance Testing processes in an accurate and timely manner
• Working cross functionally to develop fully informed views and insights into the drivers behind the data, and presenting findings clearly and concisely
• Accurately gathering, synthesizing, analyzing, and communicating timely relevant information to support decision making and to develop process improvement strategies
• Developing strategic plans for Provider Enrollment resources and ensuring goals and objectives are properly defined, implemented and tracked to execution

What we are looking for:  

A successful candidate will have a demonstrated track record of a combination of these values, knowledge, and experience: 

Values:

• Collaborative: Demonstrates the ability to work well with others to accomplish a goal and get the work done; takes opinions of others into consideration; includes others in the decision-making process
• Customer-focused: Puts customer (internal and external) needs first and makes customers their top priority
• Resourceful: Proactive willingness to utilize available information and tools to figure things out
• Communication: The ability to speak, write, and listen clearly and consistently
• Relationship Building and Maintenance: The ability to create and nourish healthy, strong relationships, as the face of Sound
• Teamwork: Demonstrates the ability to pull people together into highly effective teams along with ability to work in a highly matrixed organization
• Critical Thinking: Demonstrates the ability to be proactive, anticipate needs; ability to make good decisions with incomplete, ambiguous information
• Motivated: Demonstrates the ability to succeed and get things done at a high level of achievement
• Strategic Thinking: Demonstrates the ability to look at the big picture and proactively develop a plan of action
• Visionary: Demonstrates the ability to see, articulate and share the future of the organization in ways that engage and motivate those around them with a clear vision and plan for the future

Knowledge: 

• Bachelor’s degree or equivalent experience
• Advanced understanding/knowledge of computer data entry, All Microsoft Office suite products, and ability to navigate through any business related software

Experience: 

• 5-7 years in in enrollment/credentialing/Provider Data Management and degree in a related area and 4-7 years of experience in a clinical, revenue cycle, and/or physician practice setting
• 3-5 years of experience managing teams, contracting budgets and strategic projects (outsourcing, implementation of systems, mergers & acquisitions, etc.)
• Ability to work in a group setting, compete projects independently within established timeframes

Sound Physicians is an Equal Employment Opportunity (EEO) employer and is committed to diversity, equity, and inclusion at the bedside and in our workforce. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, gender identity, sexual orientation, age, marital status, veteran status, disability status, or any other characteristic protected by federal, state, or local laws. 

This job description reflects the present requirements of the position.  As duties and responsibilities change and develop, the job description will be reviewed and subject to amendment.