Medical Staff Credentialing Manager jobs in Florida

Company Description

ChenMed is transforming healthcare for seniors. We provide big answers to big problems in health care delivery.

ChenMed is a full-risk primary care market leader with an innovative philosophy, unique physician culture and end-to-end customized technology. These things allow us to provide world-class primary care and coordinated care to the most vulnerable population – moderate- to low-income seniors who have complex chronic diseases.
Through our innovative operating model, physician-led culture and empowering technology, we are able to drive key quality and cost outcomes that create value for patients, physicians and the overall health system.

Our model allows us to practice medicine the way it should be practiced. By recruiting focused physicians and reducing their doctor-to-patient ratios, we increase patients’ “face time” during each monthly appointment and help foster stronger doctor-patient relationships. Our model also drives and enhances compliance with treatment plans.

As a result of our efforts, our patients realize lower hospital admissions. Their overwhelming response to our approach is reflected in our aggressive, organic growth and net promoter scores in the low to mid 90s, which is unheard of in any industry. Read more about our results and the value of the ChenMed model.

As a company, we are making a difference in the lives of seniors and the health care system overall.

Job Description

The Credentialing Manager is responsible for managing a team of credentialing professionals and is accountable for systems and processes that ensure compliance with organizational credentialing policies and procedures, and compliance with the credentialing requirements of our health plan partners, and related regulatory and accrediting agency requirements. This individual will oversee the initial and ongoing application process for all clinicians and is responsible for: maintaining the organization’s credentialing databases and online systems, maintaining up-to-date credential files, and managing all health plan enrollments and reappointments, as well as, managing all initial and ongoing applications for medical staff privileges at ChenMed designated facilities.

Primary Duties and Responsibilities:

Qualifications

• Bachelor’s degree in business administration or health care related field required.
• Strong understanding and use of web-based credentialing applications. Experience with MDStaff preferred.
• Working knowledge of NCQA, AAAHC, JCAHO, AOA, URAC and other applicable accreditation and regulatory standards
• Database management skills including querying, reporting, and document generation.
• Five to Seven (5-7) years of Credentialing experience required.
• Two (2) year experience in a Lead/Management capacity required.
• Certified Provider Medical Services Management (CPMSM) / Certified Provider Credentialing Specialist (CPCS) Certification preferred (Required to obtain certification within 6-12 months of hire).

Additional Information

• Advanced knowledge of Microsoft Office Software (Excel, Access, and Word), database administration and scanning applications.
• Strong organizational, verbal and written communication skills.
• Ability to work effectively with staff, physicians and external customers.
• Ability to work independently with limited supervision.
• Multi-tasking and knowing how to set priorities.
• Fluent in English.
EDUCATION / SPECIALIZED KNOWLEDGE REQUIREMENTS: