Credentialing Manager with Security Clearance
Job Details Job DescriptionManages a team tasked with providing credentialing, recredentialing, and privileging of network providers.
Oversees all credentialing functions and applies overall advanced knowledge of the DoD credentialing and privileging process, including relevant policies, guidelines, and regulations.
Maintains overall responsibility for product quality and control of work produced by those processing credentialing transactions to ensure the accuracy, timeliness and thoroughness of all reports and materials.
Establishes performance and productivity standards to meet the contract specifications.
Holds the team responsible for completing Primary Source Verification (PSV) in accordance with policies and procedures.
Provides individual and team coaching, and counseling as required Handles and oversees the processing of provider applications and re-applications.
Establishes performance and productivity standards to meet the contract specifications.
Maintains overall responsibility for product quality and accuracy.
Overall responsibility for ensuring appropriate data in the DoD Centralized Credentials Quality Assurance System (CCQAS) is loaded accurately.
Establishes and maintains updated CCQAS records.
Communicates with providers concerning credentialing status and responds to requests for provider information.
Provides required documents to clients to make accession, credentialing and privileging (C&P) decisions.
Maintains relationships with Military Treatment Facilities and supported customers.
Ensures providers are credentialed, appointed, and privileged with health plans, hospitals, and patient care facilities.
Supports, coordinates, and facilitates any adverse action activities in accordance with regulations and policies.
Maintains current knowledge of DoD credentialing and privileging process, including relevant policies, guidelines, and regulations.
Enforces regulatory compliance and quality assurance at a healthcare facility, insurance group, or similar organization, ensuring that physicians and healthcare facilities or organizations follow relevant regulations.
Overall responsibility for leading the program, department, or functional area as designated.
Oversees, directs, and mentors subordinate staff; communicates job expectations and enforces organizational policies, procedures and core values; responsible for recruiting staff, approving timecards, and conducting performance reviews and disciplinary measures.
Minimum Qualifications Bachelor's Degree in healthcare or business field preferred or equivalent relevant experience Certified Provider Credentialing Specialist (CPCS) preferred 6-8 years of experience performing physician credentialing at a medical group, hospital or health plan and 2-5 years of management experience Other Job Specific Skills Strong customer focus, interpersonal, collaboration, written/verbal communication, prioritization and computer skills.
Excellent attention to detail and good organizational capability.
Exceptional analytical skills.
Able to handle multiple simultaneous tasks and complete work projects in designed time frames.
Knowledge of Department of Defense credentialing guidelines preferred.
Experience using Centralized Credentials Quality Assurance System (CCQAS) and Defense Medical Human Resources System - internet (DMHRSi) preferred.
Ability to handle confidential information on a daily basis in a professional manner.
Ability to consistently maintain quality and production expectations.
Possesses proof-reading skills sufficient for auditing documents.
Demonstrates advanced knowledge on credentialing policies, guidelines, and regulations for the DoD credentialing process.
#cjpost Recommended Skills Analytical Attention To Detail Auditing Certified Provider Credentialing Specialist Communication Confidentiality Estimated Salary: $20 to $28 per hour based on qualifications.
Oversees all credentialing functions and applies overall advanced knowledge of the DoD credentialing and privileging process, including relevant policies, guidelines, and regulations.
Maintains overall responsibility for product quality and control of work produced by those processing credentialing transactions to ensure the accuracy, timeliness and thoroughness of all reports and materials.
Establishes performance and productivity standards to meet the contract specifications.
Holds the team responsible for completing Primary Source Verification (PSV) in accordance with policies and procedures.
Provides individual and team coaching, and counseling as required Handles and oversees the processing of provider applications and re-applications.
Establishes performance and productivity standards to meet the contract specifications.
Maintains overall responsibility for product quality and accuracy.
Overall responsibility for ensuring appropriate data in the DoD Centralized Credentials Quality Assurance System (CCQAS) is loaded accurately.
Establishes and maintains updated CCQAS records.
Communicates with providers concerning credentialing status and responds to requests for provider information.
Provides required documents to clients to make accession, credentialing and privileging (C&P) decisions.
Maintains relationships with Military Treatment Facilities and supported customers.
Ensures providers are credentialed, appointed, and privileged with health plans, hospitals, and patient care facilities.
Supports, coordinates, and facilitates any adverse action activities in accordance with regulations and policies.
Maintains current knowledge of DoD credentialing and privileging process, including relevant policies, guidelines, and regulations.
Enforces regulatory compliance and quality assurance at a healthcare facility, insurance group, or similar organization, ensuring that physicians and healthcare facilities or organizations follow relevant regulations.
Overall responsibility for leading the program, department, or functional area as designated.
Oversees, directs, and mentors subordinate staff; communicates job expectations and enforces organizational policies, procedures and core values; responsible for recruiting staff, approving timecards, and conducting performance reviews and disciplinary measures.
Minimum Qualifications Bachelor's Degree in healthcare or business field preferred or equivalent relevant experience Certified Provider Credentialing Specialist (CPCS) preferred 6-8 years of experience performing physician credentialing at a medical group, hospital or health plan and 2-5 years of management experience Other Job Specific Skills Strong customer focus, interpersonal, collaboration, written/verbal communication, prioritization and computer skills.
Excellent attention to detail and good organizational capability.
Exceptional analytical skills.
Able to handle multiple simultaneous tasks and complete work projects in designed time frames.
Knowledge of Department of Defense credentialing guidelines preferred.
Experience using Centralized Credentials Quality Assurance System (CCQAS) and Defense Medical Human Resources System - internet (DMHRSi) preferred.
Ability to handle confidential information on a daily basis in a professional manner.
Ability to consistently maintain quality and production expectations.
Possesses proof-reading skills sufficient for auditing documents.
Demonstrates advanced knowledge on credentialing policies, guidelines, and regulations for the DoD credentialing process.
#cjpost Recommended Skills Analytical Attention To Detail Auditing Certified Provider Credentialing Specialist Communication Confidentiality Estimated Salary: $20 to $28 per hour based on qualifications.
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