Medical Staff Credentialing Manager manages staff that process credentialing and recredentialing applications for health care providers. Oversees department operations to ensure compliance with all regulatory standards. Being a Medical Staff Credentialing Manager implements policies and procedures to ensure that applications are properly verified and accurately uploaded into an online credentialing database system. Analyzes reports on applications and credentialing status to identify trends and improve the credentialing process. Additionally, Medical Staff Credentialing Manager prepares files for 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 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)
Supports the centralized credentialing program and related tasks for Physician and Advanced Practice Professional (APP) applications. This includes overseeing, monitoring, and maintaining all activities in the credentialing process to ensure compliance with regulatory, legal and company requirements and standards.
- Requires a Bachelor's Degree in Business, Healthcare or related field. Work experience can substitute on a year for year basis for the required degree.- Require Certified Provider Credentialing Specialist (CPCS) certification; or must be eligible to sit for exam within three (3) years from date of hire.- Require one (1) year of experience in medical staff services, physician credentialing, or related experience.
- Prefer the ability to develop and maintain effective relationships with medical staff and other professionals in order to engender confidence, respect and dependability.- Prefer demonstrated organizational, written, and oral communication skills.- Prefer the ability to work at a high level of accuracy and within the required timelines.- Prefer the ability to adapt to rapidly changing priorities, remain flexible and act as a team player.- Prefer demonstrated effective organizational skills with the ability to manage multiple tasks and priorities.- Prefer demonstrated ability to problem-solve and make decisions independently yet takes direction when needed.- Prefer extensive knowledge of accreditation standards and other regulatory agencies and knowledge of verification sites and modalities.- Prefer the ability to understand legal ramifications of the process and interpret rationale for performing verification.- Prefer working knowledge of business software systems, including standard desktop office applications (Microsoft Office products) and incorporation of technology into all operational functions.
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