Director, Credentialing & Accreditation

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🕒 Outubro 8

🗽 New York – Remoto

🗽 New York – Remote

💵 $109.000 - $163.600 / ano

⏰ Tempo Integral

🔴 Especialista

👔 Diretor

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• Aberta há 36 dias.
• As vagas desta empresa costumam ser preenchidas em 35 dias.

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UR Ventures

SiteLinkedInTodas as Vagas

11 - 50 funcionários

📚 Educação

🤝 B2B

🔬 Ciência

Education • B2B • Science

A UR Ventures é o braço de inovação e comercialização da Universidade de Rochester, focada em avançar a pesquisa e o empreendedorismo acadêmico. Ela conecta professores e pesquisadores da universidade com parceiros da indústria para facilitar o desenvolvimento de novas tecnologias e negócios que possam impactar positivamente a sociedade. A UR Ventures promove a colaboração, a criatividade e a transferência de conhecimento, contribuindo assim para a missão da universidade de tornar o mundo sempre melhor.

Descrição

• Provide operational and regulatory leadership for enterprise credentialing, recredentialing, clinical privileging, accreditation, and medical staff compliance activities • Translate senior leadership direction into operational plans, performance expectations, policies, and controls • Oversee credentialing, privileging, certification/accreditation, and related operational managers • Serve as the primary escalation point for complex files, compliance concerns, and cross-functional issues • Partner with medical staff leaders, hospital administration, quality, compliance, legal, IT, payer enrollment, and affiliated organizations • Lead primary source verification, ongoing monitoring, application and file review, and timely approval workflows • Support operational planning, resource allocation, vendor and contract oversight, budget monitoring, risk management, and communications • Lead, coach, and evaluate managers, supervisors, and assigned staff • Direct readiness and compliance activities for TJC, CMS, NCQA, New York State DOH, OSHA, NPDB, delegated payers, and other standards • Oversee accreditation surveys, regulatory reviews, delegated credentialing audits, internal assessments, corrective action plans, and remediation • Develop, review, route, implement, and maintain credentialing, privileging, reappointment, monitoring, and accreditation policies and procedures • Oversee specialty-specific, criteria-based privilege forms and OPPE/FPPE processes • Prepare and review files, agendas, recommendations, and documentation for credentials committees, medical executive committees, and governing boards • Guide complex or adverse credentialing matters and monitor licenses, DEA registrations, board certifications, health requirements, sanctions, exclusions, and NPDB reports • Serve as subject matter expert and escalation resource for credentialing, privileging, accreditation, and medical staff compliance • Maintain professional knowledge through associations, education, conferences, and regulatory updates

🎯 Requisitos

• Bachelor's degree in business, health care administration, health information management, or a related field and 6 years of progressively responsible experience in medical staff services, credentialing, privileging, and accreditation required • Equivalent combination of education and experience accepted • Demonstrated experience supporting regulatory surveys, accreditation reviews, delegated credentialing audits, policy development, corrective action plans, and sustained compliance monitoring required • Advanced knowledge of medical staff credentialing and privileging principles and applicable TJC, CMS, NCQA, DOH, OSHA, NPDB, and delegated credentialing requirements required • Demonstrated ability to establish performance measures, analyze operational data, improve workflows, manage change, and lead teams through organizational or technology transformation required • Excellent written, verbal, interpersonal, and presentation skills required • Master's degree preferred • Experience with OPPE/FPPE, criteria-based privilege development, medical staff committee and governing board processes, and complex credentialing issue resolution preferred • CPMSM certification preferred • CPCS certification preferred • Attainment of an applicable NAMSS certification within an organization-established timeframe preferred

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