Company Name Withheld
Job type full-time number of hires for this role 1
(cpmsm) or (cpcs) certification (preferred)
Full job description
This is a permanent remote opportunity to join pediatric associates, the nation’s largest privately owned primary care pediatric practiceSince opening its first office in hollywood, florida, pa has expanded throughout florida and recently entered the states of texas and californiaAcross our footprint, pa serves over 1 million active patients through 2.5 million annual patient visits at over 100 locations while employing over 450 cliniciansIn addition to pa’s physical footprint, we serve over 20,000 patients per month on kidzdocnow — the leading pediatric telemedicine platform in the countryPediatric associates places the utmost emphasis on quality, often exceeding the 90th percentile in pediatric specific hedis measures, maintaining patient centered medical home accreditation, and is the national leader in pediatric value based carePa provides care for over 400,000 patients across our footprint through reimbursement mechanisms other than fee for service.
We are in search for a credentialing director who will structure the department, identify technologies and platforms, improve processes and lead the vision and strategy for credentialing on a national level at pediatric associates.
Apply to join our growing pediatric associates family, today!!!
Primary function: the director of credentialing is responsible for all aspects of licensure and credentialing processes for the cliniciansDevelops and implements policies and protocols related to clinicians and pa’s credentialing verifications to ensure the company is in compliance and industry standards and best practices are appliedEnsures corporate growth initiatives are supported with regards to credentialing and privilegingThis individual and team play a key role in linking operations and systems to ensure credentialing functions are in sync with corporate growth initiatives.
Reports to: vice president of analytics-value based care
Supervisory responsibilities: supervises other employees to include evaluating and completing annual evaluationsInstructs other employees in methods or procedures needed to carry out their job as well as makes work assignmentsResponsible for overseeing all aspects of staffing for the credentialing department to include hiring, training, directing, and coaching.
Essential functions of the job: (this list may not include all of the duties that may be assigned.)
1Credentialing and privileging
· develops and maintains credentialing/privileging policies and procedures in compliance with industry standards and best practices, local, state, and federal laws and regulatory requirementsCoordinates and participates in quality improvement activities to ensure compliance and continuous enhancements of credential/privileging processes.
· oversees and maintains the data integrity and functionality of credentialing database; generates reports and prepares audits as requested.
· function as primary contact for all internal and external inquiries regarding credentialing and privileging, and potential and/or existing practitioners regarding credentialing.
Oversees and ensures that all necessary licenses and credentials are verified and updated for the respective healthcare facilityThis might include conducting background checks through finger printing, contacting licensing boards, reviewing license applications, obtaining education information and interviewing references.
Develop strategic processes to improve and achieve optimal efficiency in accurate/completeness file processing
· advises leadership on changing regulatory requirements and implications for the company's business model and strategic goals.
· responsible for providing oversight and management of department budgeting and forecasting, goals, and initiatives.
· develop and maintain kpi and reports to ensure optimal performance and responsiveness to internal and external stakeholders
· hire, develop, coach, appraise, reward and retain a highly qualified credentialing department staff; motivate and mentor credentialing staff; lead by example through appropriate participation and involvement in and oversight of credentialing activities.
· plan, provide continuity, and lead succession planning efforts for all credentialing positions.
· leads, manages, and ensures optimal training and mentoring for the credentialing team.
· monitors and evaluates the performance of staff; gives timely feedback; and manages all aspects of staffing to include hiring, training, rewarding, disciplining, and terminating staff.
Education: bachelor’s degree required or 10 years of experience to commensurate education.
Certified professional medical services management (cpmsm) or certified provider credentialing specialist (cpcs) certification, preferred
Experience: minimum 5 years of credentialing and management experience requiredPrevious healthcare required.
Knowledge, skills & abilities:
· attention to detail and ability to manage multiple deadlines coupled with the ability to think and act strategically.
· ability to ensure integrity of information and workflow processes.
· ability to inspire trust and teamwork and motivate staff to work diligently and collaboratively.
· effective at establishing and cultivating strong relationships to work collaboratively with others to achieve common goals and objectives.
· strong organizational skills that reflect ability to perform and prioritize multiple tasks seamlessly with excellent attention to detail.
· expert level written and verbal communication skills.
· demonstrated proactive approaches to problem-solving with strong decision-making capability.
· demonstrated ability to work well with people from a wide diversity of demographic and cultural characteristics; must be capable of achieving results while maintaining an inclusive, collaborative leadership style.
· forward looking thinker, who actively seeks opportunities and proposes solutions.
· technology savvy for web-based instructional techniques and tools.
· computer proficiency, including ms word, excel, outlook, powerpoint, internet tools.
· follows hipaa, compliance, privacy, safety and confidentiality standards at all times.
· promotes excellent public relations and customer service to internal and external customers.
· adapts and is willing to learn new tasks, methods, and systems.
· consistently adheres to the time management policies and procedures.
· proven ability to work in a fast-paced, highly dynamic environment.
Job type: full-time
Paid time off
Monday to friday
Credentialing: 6 years (required)
National level credentialing: 2 years (required)
(cpmsm) or (cpcs) certification (preferred)
Company's facebook page:
Waiting period may apply
Remote interview process
Personal protective equipment provided or required
Social distancing guidelines in place
Sanitizing, disinfecting, or cleaning procedures in place