Medical Staff Credentialing Manager jobs in Asheville, NC

Description

Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve.

Summary:
The Credentialing Manager is responsible for building and overseeing a team that manages all aspects and operations of provider credentialing processes. This position is responsible for maintaining compliance in accordance with state, federal and regulatory agency standards.

Responsibilities:
Responsibilities And Scope

Manages business operations of the department to accurately perform all activities related to provider credentialing functions. Directs the output of a team of employees engaged in credentialing of providers. Resolve the most complex problems related to credentialing.

Supports, participates and contributes to the development and growth of credentialing functions. Expands and provides expert knowledge and direction to the growth of the department with focus on always creating the most efficient processes for the success of future endeavors of the department and organization. Serves as a resource for internal customers. Serves as a resource for external customers defined as providers, peer health care organizations, payers and anyone else in need of assistance or information.

Manages staff including interviewing and selecting qualified candidates, coaching for career development, training, monitors productivity and accuracy and conducts performance evaluations. Serves as primary resource to employees with regards to issues, interpretation and application of organization and department policies and procedures.

Demonstrates system expertise in all current technologies. Active and critical participation in reviewing potential new software opportunities, including selection, creation, design, training and problem solving within current and new technology.

Analyzes and implements process improvements to enhance efficiency of credentialing. Conducts on-going program evaluations and audits of data integrity. Ensures accurate outcomes and compliant procedures to meet organizational fiscal, strategic and service goals. Participates actively in internal department and organization, State and Federal audits. Reviews credentialing and re-credentialing applications. Seeks primary sources for credential verification if not done by the UNC Central Credentialing Office. Coordinates with practice management, licensing agencies, insurance carriers, and other appropriate organizations to complete credentialing and re-credentialing applications.
PARDEE

Other information:
Qualifications

Required
Bachelor’s degree or equivalent combination of education and experience required.
Minimum of five years (5) credentialing experience including supervisory experience.

Preferred
Certified Provider Credentialing Specialist (CPCS) and Certified Professional in Medical Staff Service Management (CPMSM) certification



01.9591.7824

Job Details

Legal Employer: Pardee - HCHC

Entity: Pardee UNC Health Care

Organization Unit: Medical Staff Office

Work Type: Full Time

Standard Hours Per Week: 40.00

Work Assignment Type: Onsite

Work Schedule: Day Job

Location of Job: PARDEEHOSP

Exempt From Overtime: Exempt: Yes