Director, Credentialing & Accreditation

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🔥 0 minutes ago

🗽 New York – Remote

🗽 New York – Remote

💵 $109k - $163.6k / year

⏰ Full Time

🔴 Lead

👔 Director

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UR Ventures

WebsiteLinkedInAll Job Openings

11 - 50 employees

📚 Education

🤝 B2B

🔬 Science

Education • B2B • Science

UR Ventures is the innovation and commercialization arm of the University of Rochester, focused on advancing research and academic entrepreneurship. It connects university faculty and researchers with industry partners to facilitate the development of new technologies and businesses that can positively impact society. UR Ventures promotes collaboration, creativity, and knowledge transfer, thereby contributing to the university's mission of making the world ever better.

📋 Description

• 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

🎯 Requirements

• 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