Medical Staff Credentialing Manager

Fredericksburg, VA
Nov 25, 2021
Nov 27, 2021
Full Time
Medical Staff Credentialing ManagerJob Summary/ObjectiveOversees day-to-day activities of staff that process credentialing and recredentialing applications for clinical providers. Ensures that applications are properly verified and accurately uploaded into an online credentialing database system. Administers systems for tracking license and certification expirations to ensure our providers have active licenses. Supervises a small group of professional staff in an organization characterized by highly transactional or repetitive processes. Development of processes and procedures. Thorough knowledge of functional areas under supervision.Salary/Total Compensation$65,000 - $75,000 depending on experienceExtremely competitive compensation and benefits package.Healthcare, Dental, Vision, and life insurance benefits - additional coverage options available such as Short Term Disability, Long Term Disability, Group Accident Insurance401K with 3% employer matchPaid Time OffCompany TrainingAccelerated career advancementEssential FunctionsEnsures that applications are accurately completed and the correct process is followed by staff.Provide ad-hoc reporting and special projects when requested.Manage small staff in day-to-day personal activities and ensure the team is equipped to handle upcoming growth at all times.Maintain confidentiality of informationLead licensing and/or payer credentialing process as we scale our clinical care team across multiple states and payersOwn relationship management with relevant 3rd party partnerships including but not limited to licensure & credentialing partners, state boards, and health plan payers. This may include providing necessary resources, and deliverables to ensure effective management of the provider roster to mitigate any risks associated with growth and expansion as well as to drive efficiencies in processAssist Human Resources in provider onboarding as it relates to primary source verification, initial credentialing, and other key requirements to inform key decisions on hiring and onboarding. HR serves as the initial reviewer; the Licensing Specialist is the final reviewer of the provider/applicant's licensing and medical credentialing applications to ensure compliance with each entity's specific requirements and standards including state and federal regulatory requirementsCross-Licensure Oversight: Partner with relevant vendors and/or providers to identify and manage key cross-licensure opportunities as we grow and scale our clinician team. This includes serving as the project manager to drive forward an internal process including communication with providers as well as regular reporting to the Operations teams on licensure and credentialing statuses and timelines to align the launch and implementation of new businessCompetency / Knowledge, Skills, and AbilitiesLeadership: The ability to direct and contribute to initiatives and processes within the organization.Project Management: Ability to organize and coordinate work within schedule constraints and handle emergent requirements in a timely manner.Multitasking: Ability to monitor important and complex projects concurrently.Communication: Ability to effectively communicate orally and in writing, including writing and preparing emails, letters, order updates/correspondence within our computer systems, and other official correspondence.Computer Competency: Requires intermediate to advanced skills in Excel, knowledge of Microsoft Office, Google mail and docs, and other software.Customer Service: Ability to deliver and ensure customer satisfaction with a healthcare professional licensing product through superior administration and communication.Initiative/Self-Starter: Ability to assess and initiate actions independently, with little coaching or supervision. Ability to distill complex licensing and credentialing concepts into clear frameworks, operational flows, training materials, and KPIs for measurementProblem Solving: Ability to use prescribed or ad hoc methods, in an orderly manner, for finding solutions to problems.Position Type and Expected Hours of WorkFull-time position with hours of work being 8:00 AM - 5:00 PM, with a 1-hour lunch, Monday through Friday.Permanent remote positionEducation and Experience (Minimum Requirements)3+ years of experience tracking and managing medical licenses of all billable provider types and payer credentialing of large-scale clinical teams across multiple payers. Ideally, across multiple states.3 years with proven management experience with direct reportsDeep understanding of medical licensure and credentialing nuances across payers and states, with keen attention to risk management.Behavioral Health experience is a plus.Learn more about Thriveworks' mission and core values at -counseling/mission-and-vision/

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