Medical Staff Credentialing Manager jobs in Miami, FL

Medical Staff Credentialing Manager manages staff that process credentialing and recredentialing applications for medical providers. Implements policies and procedures to ensure that applications are properly verified and accurately uploaded into an online credentialing database system. Being a Medical Staff Credentialing Manager presents files to the credentialing committee and may act as a liaison to state medical licensure boards regarding the status of license applications. Analyzes and prepares reports on trends in application status. Additionally, Medical Staff Credentialing Manager typically requires a bachelor's degree. Typically reports to a director. The Medical Staff Credentialing Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. To be a Medical Staff Credentialing Manager typically requires 5 years experience in the related area as an individual contributor. 1-3 years supervisory experience may be required. Extensive knowledge of the function and department processes. (Copyright 2024 Salary.com)

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Credentialing Manager
  • DOCTORS HEALTHCARE PLANS, INC.
  • Coral, FL FULL_TIME
  • Scope of Position: Manages staff that process credentialing and recredentialing applications for medical providers and present them to credentialing committee, by implementing and enforcing policies and procedures to ensure that applications are properly verified and accurately uploaded into an online credentialing database system. Manages day to day process to timely process of Initial Credentialing / Recredentialing of application, processing incoming and outgoing documents, and requesting required credentials documents.

    Key Responsibilities:
    • Manages the Provider Credentialing functions for the plan        
    • Supervises and trains the Credentialing Staff
    • Creates and revises credentialing policies, procedures and workflows, to ensure compliance with all regulatory and contractual credentialing requirements
    • Conducts oversight of the delegated credentialing process for appropriate subcontractors
    • Organizes and oversees the Credentialing Committee process
    • Maintains continuous monitoring databases for NPDB, Medicare Opt-out and Licensure
    • Familiarity with Credentialing and Re-credentialing variety of physician specialties, allied health providers and ancillaries
    • Performs other duties as assigned
    Qualifications:
    • Bachelor’s degree in Health Administration or related field, preferred
    • Minimum of three (3) years of supervisory or management level experience in managed care, medical staff services, health services or government assistance programs; or an equivalent combination of education and experience which would provide the required knowledge, skills and abilities to perform the job duties.
    • Current Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Staff Management (CPMSM) with the National Association of Medical Staff Services is preferred
    • Familiarity with NCQA and AAAHC accreditation standards
    • Good verbal communication skills (Fluent in Spanish - preferred but not required)
    • Excellent organizational skills
    • Extremely detail-oriented
    • Knowledge of basic medical terminology.
    • Ability to analyze data and make appropriate decisions.
    • Ability to work as a team under stressful conditions.
    • Good verbal communication skills (Fluent in Spanish - preferred but not required)
    • Excellent organizational skills.
    • Extremely detail-oriented.
    • Ability to maintain confidentiality.
    • PC proficiency and Windows®-based software knowledge (Microsoft Word, Excel, Outlook) required.

    Note:  This description indicates, in general terms, the type and level of work performed and responsibilities held by the team member(s).  Duties described are not to be interpreted as being all-inclusive or specific to any individual team member.   

    No Third Party Agencies or Submissions Will Be Accepted.   

    Our company is committed to creating a diverse environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. DFWP   

    Opportunities posted here do not create any implied or express employment contract between you and our company / our clients and can be changed at our discretion and / or the discretion of our clients. Any and all information may change without notice. We reserve the right to solely determine applicant suitability. By your submission you agree to all terms herein.


     
  • 7 Days Ago

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Provider Credentialing Manager
  • 10X Health System
  • Aventura, FL FULL_TIME
  • POSITION SUMMARYAs a Provider Credentialing Manager, you will be responsible for managing the onboarding process for healthcare providers, ensuring that all necessary credentials are obtained, and the...
  • 4 Days Ago

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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 opportunitiesWorks with providers and netw...
  • 2 Days Ago

1
Field Reimbursement Manager, Oncology – South Florida
  • 10000202 - Account Manager
  • Miami, FL FULL_TIME
  • Field Reimbursement Manager, Oncology – South FloridaJoin our industry-leading BioPharmaceuticals team at AstraZeneca, where you can make an impact on patients with our leading pipeline! This field-ba...
  • 6 Days Ago

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Gig Work Mentor - Social Media Manager
  • Social Media Manager - Fud
  • Miami, FL OTHER
  • Fud, the World's First Social Hustling Community, is seeking a Gig Work Mentor - Social Media Manager to join our team. As a Gig Work Mentor, you will play a vital role in supporting and mentoring ind...
  • 1 Month Ago

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Clerk, Medical Staff Services
  • South Miami Hospital
  • Miami, FL FULL_TIME
  • Baptist Health South Florida is the largest healthcare organization in the region, with 12 hospitals, more than 27,000 employees, 4,000 physicians and 100 outpatient centers, urgent care facilities an...
  • 3 Days Ago

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

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 Manager jobs
$87,470 to $120,233
Miami, Florida area prices
were up 2.9% from a year ago

Medical Staff Credentialing Manager in Wichita Falls, TX
With the growing numbers of employed practitioners, hospitals and health systems are looking at delegated credentialing to speed up the provider enrollment process and reduce accounts receivable write-offs and claim holds which delay or decrease the revenues received from payers for the services provided to patients.
December 04, 2019
Medical Staff Credentialing Manager in Memphis, TN
Medical staff services professionals deal with credentialing every day, but how do background checks complement this critical process.
February 18, 2020
Medical Staff Credentialing Manager in Lima, OH
Medical staff services is a self-governing body within a healthcare organization and is responsible for keeping with independent practitioners who serve healthcare facilities.
January 24, 2020