Katie's Way · 5 months ago
Director, Credentialing
Kansas City, MO
Full-time
Onsite
Director/Executive
10+ years expKatie’s Way is dedicated to addressing mental health challenges and was founded by Dr. Jeffery Mathis. The organization is seeking a full-time Director, Credentialing to oversee the verification and maintenance of healthcare provider credentials, ensuring compliance with licensing, certification, and regulatory standards.
Mental Health Care
Responsibilities
Leads the credentialing process for all healthcare providers, including initial application review, primary source verification, and ongoing re-credentialing
Manages a team of credentialing specialists as needed to ensure accurate and timely processing of applications
Maintains comprehensive credentialing files with current, required documentation for each provider
Monitors credentialing databases like CAQH and PECOS for updates and data integrity
Develops and implements compliance policies and procedures to adhere to federal, state, and industry regulations
Conducts regular compliance audits and assessments to identify potential risks and non-compliance issues
Investigates and addresses compliance concerns, including corrective action plans
Stays informed about changes in healthcare regulations and ensuring the organization adapts accordingly
Ensures Staff Training and Education in Compliance
Provides ongoing training to healthcare staff on credentialing guidelines and compliance requirements
Educates providers on documentation practices and necessary compliance standards
Generates reports on credentialing status and compliance metrics to leadership
Identifies trends and areas for improvement within the credentialing and compliance processes
Act as a strategic partner to the executive team
Promote a positive organizational culture and support DEI initiatives
Documents concisely, precisely, and accurately on all records or documents as indicated by policy
Maintains confidentiality of all employees, patients, clients, and company information
Participates in team meetings and professional development activities
Qualification
Required
Bachelor's degree in a relevant field such as Business, Health Care Administration, or another relevant field
Minimum of 10 years' work experience performing similar credentialing and compliance leadership functions (healthcare credentialing, managing credentialing processes, verifying provider credentials, and navigating regulatory compliance)
In-depth knowledge of healthcare regulations, accreditation standards, medical staff bylaws, Medicare, state licensing requirements, and credentialing best practices
Proven track record in creating and effectively managing credentialing procedures and best practices
Effective leadership and project management skills
Proficient analytical and problem-solving abilities to identify and address compliance risks
Proficiency in using credentialing software and databases
Proficiency using Microsoft Office Suite
Effective communication skills to collaborate with diverse stakeholders, providers, legal counsel, and regulatory agencies
Proficient organizational, time management and follow up skills
Team oriented and possess a positive attitude with a demonstrated ability to collaborate effectively with others to achieve departmental and company objectives
Professionalism, discretion, and confidentiality
Desire and commitment to promote and share Katie's Way mission, vision, values, and culture
Willingness and ability to travel as needed
Preferred
CPCS or CPMSM certification
Prior experience in creating and implementing credentialing and compliance processes, programs, and training
Benefits
Medical
Dental
Vision
Life
Disability
Voluntary programs such as STD, LTD, Critical Illness, Legal Shield, and others
Competitive PTO program
Immediate match and vesting in our 401(k) Plan
Company
Katie's Way
Revolutionizing Mental Health Care for Our Military Community At Katie's Way Plus, we are more than a specialized mental health provider; we are dedicated advocates and innovators committed to serving our brave military members and their dependents.
51-200 employees
Funding
Current Stage
Growth StageCompany data provided by crunchbase