Director of Credentialing

🕒 Maio 27

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American Family Care

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

Fundada em 1982

Healthcare • Urgent Care • Family Care

A American Family Care é um fornecedor de saúde nacional especializado em serviços de atendimento de urgência, atendimento primário e cuidados familiares. Com forte ênfase na acessibilidade e conveniência, oferecem uma variedade de serviços médicos, incluindo tratamento para alergias sazonais, vacinas, exames físicos e atendimento de emergência, todos projetados para garantir atenção rápida e um ambiente acolhedor e cuidadoso para os pacientes. A American Family Care visa oferecer atendimento de saúde de alta qualidade a custos mais baixos em comparação com visitas tradicionais a salas de emergência, utilizando clínicas de atendimento sem hora marcada e laboratórios no local para melhorar a experiência do paciente.

Descrição

• Provide strategic leadership for all credentialing, recredentialing, privileging, and provider enrollment activities • Build, lead, and mentor a high-performing credentialing team • Develop and implement departmental goals, SOPs, KPIs, and quality assurance measures • Oversee verification of licensure, education, training, certifications, work history, malpractice coverage, and professional references • Ensure compliance with all federal, state, and local regulatory bodies • Oversee timely and accurate submission of enrollment applications • Manage external credentialing and verification vendors • Continuously evaluate and enhance credentialing workflows

🎯 Requisitos

• Bachelor’s degree in healthcare administration, business, or related field • 7 or more years of credentialing experience in a healthcare organization, MSO, medical group, ASC, or hospital • 3 or more years of leadership or management experience • Strong working knowledge of CMS, Joint Commission, NCQA, URAC, and payer credentialing and enrollment requirements • Proficiency with credentialing software systems, provider databases, and digital document management • Experience in multi-site or multi-state healthcare delivery organizations, or MSOs • Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) preferred • Proficiency with CredentialStream/Verity preferred • Experience implementing credentialing software or leading large-scale credentialing process redesign • Exceptional attention to detail and commitment to data accuracy • Strong analytical, organizational, and project management abilities • Excellent written, verbal, and presentation development skills • Ability to lead teams through change and build scalable credentialing infrastructure • High integrity, discretion, and commitment to confidentiality • Ability to work cross-functionally and influence without formal authority • Strong relationship management and customer service orientation

🏖️ Benefícios

• Comprehensive benefits package including medical, dental, vision, disability, life insurance • Matching 401(k) • Flexible work arrangements • Professional development opportunities • Paid time off