Oversees and performs credentialing services for the Jackson / Orlando Companies. Develops and implements effective procedures and collaborates with senior leadership, Clinical Liaison/ Risk Manager on policy creation or updates. Evaluates and recommends resources to expand service levels. Ensures adherence to company credentialing requirements and compliance policies. Maintains professional relations with clinicians, clients, vendors and teammates. Manages the housing and travel requests for Providers.
ESSENTIAL FUNCTIONS AND BASIC DUTIES
1. Provides leadership and management of Credentialing Department functions.
· Ensures adherence to regulatory requirements, company credentialing requirements and compliance policies while meeting established SLA’s to ensure on-time starts of assignments.
· Conducts regular internal audits.
· Works with production management to resolve issues that may prevent the start of an assignment.
· Ensure appropriate coverage and scheduling of credentialing team members to provide continuity of coverage and support.
· Participates and responds to requests for external audit processes, including Joint Commission.
· Responsible for performance management activities for credentialing team members.
2. Responsible for the effective completion of assigned credentialing functions.
· Works with clinicians to obtain required new hire paperwork and credentialing documentation to ensure on-time start of their assignment.
· Identifies facilities for clinicians to complete required medical documentation.
Set up direct pay and complete authorizations with medical facilities.
· Completes background checks, licensure verifications and education verifications for clinician as required.
· Scans and uploads all documents to our database/tracking system.
· Maintains and updates document spreadsheet.
3. Establishes and maintains effective working relationships with recruiting team members, Company associates, and with management.
· Coordinates activities with other departments and managers and participates in meetings with senior leadership.
· Keeps management well informed of activities and of any significant problems.
· Ensures effective communication among all managers and involved parties.
· Attends meetings as required.
4. Responsible for processing housing and travel requests for Providers.
· Receives and processes housing, rental care and/or travel requests through 3rd party vendor.
· Ensures that housing options meet established budget.
· Act as liaison between 3rd party vendor and Jackson/Orlando companies.
· Maintains accurate reporting and documentation of lease information.
5. Assumes responsibility for related duties as required or assigned.
· Processing of credentialing and housing related invoicing and month-end close activities.
· Performs miscellaneous projects as assigned.
· Updates job skills as required.
6. Conducts job duties in accordance with the Corporate Values and Culture
· Respects all individuals without regard to their position. Understands that there is no class system.
· Functions in a fail-safe environment that forgives and focuses on solutions. Will encourage and support other associates, creating an environment to be one’s best.
· Communicates problems directly, not engaging in rumors or gossip.
· Embraces a “Team-First” vs. “Me-First” attitude. Understands that the possibilities for success are limitless when one is impervious to who gets credit. Doesn’t take credit for other’s accomplishments and will give other’s credit with praise and recognition.
· Always tries to do what’s right with a firm sense of integrity and ethics, behaving in a manner consistent with principles of moral conduct.
1. Proper and timely credentialing of clinicians according to regulatory requirements, company and client credentialing requirements and compliance policies.
2. Act as a resource for clinician and associates for issues and questions related to credentialing processes and documentation.
3. Internal operating system tracking is current, and complete. All required records are up-to-date, accurate, and in compliance with company policy.
4. Good coordination and effective working relations exist with other departments. Assistance is provided as needed.
5. Management is well informed of activities and of any significant problems.
Education/Certification:High school graduate or equivalent. Bachelor’s Degree preferred
Experience Required:At least 2 years of experience managing teams. Experience in a credentialing/compliance role preferred.
Skills and Abilities: