Acuity Eye Group · 7 hours ago
Director Provider Credentialing
Santa Ana, CA
Full-time
Onsite
Director/Executive
8+ years expAcuity Eye Group is seeking a Director of Provider Credentialing who will be responsible for coordinating the credentialing and privileging process for medical staff and allied health professions. The role involves overseeing the accuracy of the credentialing database, ensuring compliance with regulatory requirements, and providing leadership and direction for the credentialing process.
EyewearHealth CarePersonal HealthProfessional Services
Responsibilities
Provides leadership, direction, process improvement models, and initiatives and establishes evidence-based, best practice analysis to improve/establish work standards
Responsible for leading, coordinating, monitoring, and maintaining the accuracy and integrity of the credentialing and re-credentialing process in the California Market
Develop new processes and organization with the appropriate skillset to effectively and efficiently perform credentialing including provider credentialing, hospital privilege credentialing, and payer enrollment
Individual responsibility for credentialing decisions and authorizing clinician billable service
Experienced leadership required for multi-faced environment; role primarily focuses on tactical execution. Receives assignments in the form of objectives and determines how to use resources to meet schedules and goals
Provides oversight of the process by maintaining a working knowledge of requirements of Center of Medicaid/Medicare Services ("CMS"), National Committee for Quality Assurance (" NCQA") and 3rd party insurance requirements
Works with Field Management and the Acquisition Team to identify and start the credentialing process early with as much advance notice as possible, as to not negatively affect the Company’s billing process
Provide effective leadership, coaching, counseling, evaluating, and mentoring of staff in an effort to identify and implement opportunities for improvement
Participates in Human Resources related functions, such as Interviewing, Identifying, Selecting and Developing talent, Performance Appraisals (30, 60, 90 day, annual), Disciplinary Actions, Time Card Approvals, and Salary Administration
Responsible for developing, mentoring, and guiding team members for future growth and identify resource needs with appropriate approval
Maintains an appropriate professional appearance and demeanor in accordance with Company policies
Keep commitments and keep direct supervisor informed of work progress, timetables, and issues
Maintain strict compliance with State, Federal and other regulations (e.g., OSHA, WC, HIPAA, ADA, FEHA, DOL, HR policies and practices)
Other duties as assigned by management
Qualification
Required
At least 8-10 or more years of related work experience
Operational management knowledge of medical offices
Equivalent to high school diploma or general education degree (GED)
Preferred
Associates or Bachelor's Degree
Knowledge of WORD, EXCEL, POWERPOINT and Care Cloud applications
Experience leading a team, mentoring and coaching subordinates
Experience with Credentialing of Healthcare Professionals; experience in the Ophthalmic industry
Certified Credentialing Specialist (preferred)
Company
Acuity Eye Group
At Acuity Eye Group, our vision is to create the largest network of vertically integrated ophthalmic service clinics in the US, physician-owned and professionally managed.
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
Bill Vaughan
Chief Executive Officer
Jeffrey Cho
Chief Operating Officer
Company data provided by crunchbase