Job Description

The Credentialing Director oversees and manages the projects and day-to-day operations of the Credentialing team. The primary responsibility is to ensure that each interaction throughout the credentialing process, involving providers, client contacts, and internal customers, is engaging, efficient, and effective. The Director leads a team of direct reports, providing guidance and support to manage the activities, performance, and overall direction of the team. Additionally, the Director collaborates with PA’s leaders to plan, develop, and implement strategies and systems aimed at enhancing the overall efficiency of the credentialing function, contributing to the success of the organization.

THIS JOB IS HYBRID AND REQUIRES RESIDING IN THE ATLANTA AREA.

ESSENTIAL JOB DUTIES & RESPONSIBILITIES :

• Creates and maintains a high-quality work environment so team members are motivated to perform at their highest level.
• Manages department's daily operations, including the development, analysis, and implementation of processes.
• Leads the credentialing of Go-live contracts, developing and managing strategic relationships with hospital MSOs while communicating credentialing updates throughout.
• Actively participates in credentialing process including status updates to assigned client(s) and serves as back up to team members if/as needed.
• Assumes responsibility for the effective performance of all related credentialing functions.
• Manages operational/performance metrics of credentialing team and oversees key metric reporting to company management.
• Communicates with providers regarding relevant concerns and necessary documentation/logistics.
• Creates, maintains, and distributes reports to update leadership on the team’s performance, tasks, and requirements.
• Provides continual evaluation of processes and procedures and keeps the team updated on any changes.
• Is available to Associates who experience challenges by providing appropriate coaching, direction, and resolution.
• Responds to associate relations issues and use appropriate judgment in communication with senior leadership.
• Works as a leader of special or ongoing projects that are important to foster improvement.
• Establishes and maintains internal and external relationships as an effective, contributing team leader.
• Demonstrates competency and confidence when delivering difficult conversations.
• Conducts monthly 1:1s and Yearly Performance Reviews.
• Assumes responsibility for establishing and maintaining strong business relationships with providers, clients, and internal customers.
• Maintains confidentiality of information and meets all deadlines.

QUALIFICATIONS – EDUCATION, WORK EXPERIENCE, CERTIFICATIONS :

• Bachelor’s degree preferred.
• 5+ years of experience in a credentialing position or a similar occupation, demonstrating a deep understanding of credentialing processes, procedures, and best practices.
• 3+ years of relevant experience in leadership, highlighting the ability to effectively lead and manage teams, drive performance, and provide strategic direction in a service coordinator or related environment.
• Experience with credentialing software platform (e.g. MDStaff) and CRM (e.g. Salesforce) required; utilizes technology effectively to support service coordinator functions and tasks.

KNOWLEDGE, SKILLS, AND ABILITIES :

• Knowledge of relevant regulations and quality standards applicable to service coordinator operations, ensuring compliance with regulatory requirements and adherence to quality benchmarks to maintain service excellence.
• Ability to problem solve in an ever-changing environment, proactively identifying challenges and implementing effective solutions to optimize the efficiency and effectiveness of service coordinator operations.
• Ability to work comfortably and calmly in a fast-paced, high-pressure environment, maintaining composure and effectiveness under stress to ensure smooth operations and successful outcomes.

Job Tags

Similar Jobs