Director of Credentialing
About Albion Staffing Solutions:
Albion has been offering Temp; Contract and Direct Hire Staffing Services for 20-years from offices located throughout South Florida. Offering General Admin/Clerical and Light Industrial staffing services, Albion also specializes in the Logistics, Allied Healthcare and Banking industries.
About this opportunity:
Albion's Healthcare Division has a client, a leading national physician group and practice management company established in 1953 looking to hire a Director of credentialing.
Essential Duties and Responsibilities:
- Works with Department Managers and Supervisors to insure proper credentialing, licensing, and current hospital privileges are active and kept active on an ongoing basis.
- Works with Department Heads and their teams to insure a smooth transition of providers when on-boarding for new contracts and during Acquisitions.
- Interacts with Compliance, Operations, Recruiting, and other Department Heads to assure smooth communication between departments, clear and concise work flow and NCQA rules and regulations are met.
- Develops, and monitors department performance
- Updates and maintains executive level visual presentation
- Interacts with internal and external clients on strategic initiatives related to Credentialing and onboarding providers.
- Works to assure that NCQA rules and regulations, audits and compliance needs are in place and quality issues are handled in a timely manner.
- Works with Department Heads and Departments to insure all malpractice insurance, tails and liability coverages are in place.
- Work to insure Department is maintaining “Lean” initiatives as set by Company.
- Travel as needed
- Supervise and train Credentialing Staff as needed.
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.
- Demonstrated, in-depth knowledge of credentialing
- Understanding of NCQA /JC Accreditation standards and policies and procedures
- Ability to develop and manage audit controls
- Ability to create, implement, document and audit policies and procedures
- Manage both direct and indirect remote employees and ensure internal controls are followed
- Highly analytical with the ability to demonstrate command of the details and to articulate those details at a higher level
- Achievement-oriented with a positive, results-oriented style
- Strong interpersonal skills with an ability to work effectively in a team environment
- Very strong written and oral communication skills
- Ability to effectively prioritize and execute tasks in a high-pressure environment
- Experience working both independently and in a team-oriented, collaborative environment
- Demonstrated ability in leadership and/or managing others
- Strong interpersonal, project management and mentoring skills.
- Ability to make decisions in a rapidly growing, professional, service oriented environment.
- Bachelor's Degree from four-year College or university and 10 or more years of related experience; or equivalent combination of education and experience. MBA preferred.
To perform this job successfully, an individual should have knowledge of:
- Microsoft Office Suite
- Vistar or other credentialing software.
Certificates and Licenses:
- Certified Provider Credentialing Specialist Preferred
- Trains, coaches, and mentors team
- Responsible for managing non-exempt and potentially exempt employees
- Assists with planning and conducting performance appraisals and talent assessments of staff, recommending merits, bonuses and promotions and administering corrective actions when necessary
- Responsible for managing exempt and non-exempt employees
- Plans and conducts performance appraisals and talent assessments of staff, recommends merits, bonuses and promotions and administers corrective actions when necessary
Applicants will work in the customer's facility - located in Plantation, FL
- Albion uses E-Verify to verify employment eligibility.
- Pre-Employment and random Drug and Background testing applicable.
- Only Local Candidates will be considered; no relocation provided.
- Reliable Transportation to/from the workplace is necessary.
Pay: $100,000 to $120,000/year
Job Status: Full Time