Provider Credentialing Manager - Dallas TX
Provider Credentialing Manager - Dallas TX
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Job Description
Integrative Emergency Services LLC (IES) is looking for a Provider Credentialing Manager. This role oversees all credentialing functions ensuring accurate timely and compliant of credentialing operations across all clients and service lines. This position is responsible for the strategic oversight and continuous improvement of credentialing processes team leadership and interdepartmental collaboration. This position ensures that standards timelines and quality benchmarks are consistently met while maintaining regulatory compliance and a strong customer service orientation
IES is dedicated to cultivating best practices in emergency care providing comprehensive acute care services creating value and supporting patients employees clients providers and physicians in pursuit of the highest quality health care.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Include the following. Others may be assigned.
- Provide leadership and supervision to the Credentialing team; including coaching development workload allocation and performance management.
- Oversee daily operations of credentialing functions ensuring accuracy completeness and timeliness of provider credentialing files.
- Establish and monitor key performance indicators (KPIs) and service level agreements (SLAs); analyze operational data and use metrics to drive decisions.
- Serve as escalation point for complex credentialing issues and provide subject matter expertise to internal stakeholders and clients.
- Lead planning and resource allocation for new client.
- Ensure robust audit and quality assurance programs are in place including regular review of credentialing data workflows and compliance with regulatory standards.
- Collaborate with other departments including but not limited to Enrollment Recruiting Operations and Clinical leadership to ensure seamless onboarding of clinicians.
- Ensure the team adheres to standard credentialing processes and regulatory guidelines and update SOPs as needed.
- Lead credentialingrelated project initiatives working closely with crossfunctional partners.
- Partner with IT and Business Intelligence to enhance credentialing tools and dashboards; maintain visibility into document expirations reappointments and system compliance.
- Maintain uptodate knowledge of payer and regulatory requirements and industry best practices; share guidance and lead changes accordingly.
- Foster a culture of accountability operational excellence and continuous improvement.
- Ensure that clinicians and clients receive toptier services throughout the credentialing cycle. Develop performance measurements to effectively maintain service level agreements and key performance indicators while adhering to budget. Develop and maintain dashboards for the business and/or clinical or management company leadership.
- Collaborate with Medical Directors Market Presidents and other Clinical Executive Leaders to address client or practitioner credentialing and enrollment needs and/or concerns.
- Handle sensitive information in accordance with company protocols and ensure data security.
QUALIFICATIONS
Knowledge Skills Abilities: To perform this job successfully an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Strong understanding of credentialing standards NCQA/JCAHO requirements and payer regulations.
- Experience leading teams with multiple layers (e.g. supervisors and coordinators).
- Analytical and qualitydriven mindset with a focus on operations compliance and process improvement.
- Excellent written and verbal communication skills including crossfunctional collaboration.
- Ability to manage complex issues and competing priorities in a fastpaced environment.
- Proficiency with credentialing systems (e.g. Salesforce) and Microsoft Office Suite.
- Strong customer service orientation and project management capabilities.
- Detail orientation
- Ability to use discretion appropriately and maintain confidentiality
- Ability to read write and speak English proficiently
Education / Experience: Include minimum education technical training and/or experience preferred to perform the job.
Required:
- High school diploma or GED
- Minimum 4 years provider credentialing or related experience
- Minimum 2 years prior leadership experience
Preferred:
- Bachelors degree
- Experience in a multisite healthcare services environment
PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Specific vision requirements include the ability to see at close range distance vision peripheral vision depth perception and the ability to adjust focus
- While performing the duties of this job the employee is regularly required to talk and hear
- Frequently required to stand walk sit use hands to feel and reach with hands and arms
- Possess the ability to fulfill any office activities normally expected in an office setting to include but not limited to: remaining seated for periods of time to perform computer based work participating in filing activity lifting and carrying office supplies (paper reams mail etc.
- Occasionally lift and/or move up to 2025 pounds
- Fine hand manipulation (keyboarding)
WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Office environment
- May visit hospital locations and vendors
- The noise level in the work environment is usually low
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position.
The company is committed to creating a diverse inclusive and equitable environment and is proud to be an equal opportunity employer. Qualified applicants of any age race religion nationality sexual orientation gender identity or expression disability or veteran status will receive equal consideration for positions. We welcome people of diverse backgrounds experiences and abilities and believe that the unique experiences of our team drive our success.
Required Experience:
Manager
Employment Type
Full-Time
