Medical Affairs and Credentialing Manager

Location: Marlton, NJ

Type: Full Time

Min. Experience: Experienced

Our client is a broad based healthcare provide providing hospital based programs including inpatient psychiatric services, ED evaluations, psychiatric crisis center intervention, medical/surgical floor consults, school-based programs, partial hospitalization programs, residential treatment services and healthcare services for correctional facilities. 

Medical Affairs Manager

Position Summary:

The Medical Affairs/Credentialing Manager provides leadership, management, and operational oversight day to day for the coordination and credentialing of licensed staff on pre-employment and maintaining records to ensure valid annual re-credentialing of practitioners, and organizational providers. The scope of this role is to support our client’s portfolio of hospital, correctional, outpatient contracts for delivery of Mental Health Services.  The manager oversees the process of obtaining privilege delineation, communication with internal stakeholders that oversee contracts and recruitment of Providers.

Position Requirements:

  • Develops the internal SOP’s necessary for start to end credentialing process for staff appointments, committee approval of privileges
  • Ensures the process of data entry and data integrity into the One Pen system is adhered to for review and measurement of progress on each provider
  • Associates Degree in business administration required, prefer a BS degree
  •  CPCS certification is highly desirable
  • Prior Provider credentialing experience required
  • Minimum 5 years supervisory or equivalent experience leading a team of 5 or more direct reports
  • Demonstrated success supervising team including setting team and individual goals, scheduling, work assignments, ongoing feedback, constructive guidance, performance evaluation and leading team meetings, to include payroll processing for the department utilizing Kronos.
  • Externally develops relationships with hospital medical staff office/credentialing professional review committee (PRC), to include obtaining knowledge and producing information to committee members, committee cycles and process for securing temporary privileges.
  • Thorough knowledge of the One Pen system to include extrapolating and generating reports and documents
  • Working knowledge of all credentialing requirement and standards
  • Establish written SOP communication on expected timelines of licensing by state, and committee approvals.
  • Required proficiency in Excel, Work, Access, and Power Point.

Performance Expectations:

  • High ability to think strategically and implement tactically to position the company for the future
  • Ability to identify barriers to meeting goals and implements activities to alleviate barriers
  • Coordinate budget expenditures through effective planning, monitoring and forecasting
  • Effectively lead, measure, and motivate credentialing coordinators to meet production goals
  • Promote a culture of high performance, compliance, technical competency, and professional decorum and exceptional customer service both internal/external
  • Ensure the coordination and sharing, receipt, and/or update of information among various internal department as necessary
  • Attendance to the weekly provider status meetings/calls to review progress, of provider candidates in play for current vacancies
  • Strengthen provider engagement and customer service with the Credentialing staff utilizing professional written and verbal communication
  • Strong organizational skills, including time management and ability to manage high volume of email correspondence.
  • Working knowledge of all standards/guidelines in Credentialing/Re-Credentialing and other regulatory/compliance requirements
  • Create and manage an updated document checklist needed to complete a timely credentialing process
  • Conducts or assist with the investigation of adverse or missing information and shares weekly with the internal stakeholders, which is not limited to the weekly status meetings
  • Advises applicants on the application process and on the status of their application and  information needed to complete the credentialing files
  • Query on-line databases for malpractice and sanction reports.
  • Submit a monthly productivity report  to the Executive Director of Operations
  • Performs audits regularly on the files to ensure compliance and completion
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