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United Vein & Vascular Centers · 3 weeks ago

Credentialing Manager

Tampa, FL

Full-time

Onsite

Senior Level

5+ years exp

United Vein & Vascular Centers is a life-changing healthcare innovator that is rapidly expanding access to state-of-the-art, minimally invasive vein and vascular care. The Credentialing Manager role is responsible for onboarding employed physicians and managing the credentialing process for all in-house contracted providers, ensuring compliance with policies, procedures, and regulatory requirements.

Health CareHospitalMedical

Responsibilities

Ensures all employed clinicians are onboarded to ensure they have all appropriate licensure and documents required for credentialing

Ensures employed clinicians are privileged at the SNF and hospital facilities

Ensures that all legal, licensure and accreditation standards are met

Reviews the approval and termination of professional provider contracts as they relate to the credentialing process

Ensures the accurate and timely information for the purposes of re- credentialing, data analysis and directory generation as well as recommending changes to the credentialing criteria and processes

Monitors all governmental and private agency initiatives in the credentialing area

Oversees all aspects of the physician and clinician licensing, including initial licensure, renewals, regulatory updates, and coordination with state medical boards to ensure uninterrupted practice eligibility

Ensures all credentialing and re-credentialing policies and processes are in compliance with NCQA and all applicable state regulations

Ensures credentialing activities are integrated within the appropriate QI committees and departments

Hires, trains, coaches, counsels and evaluates performance of direct reports

Acquires and maintains knowledge of the credentialing requirements of all national and state agencies, including National Committee for Quality Assurance (NCQA), URAC, or general accreditation

Maintains a primary credentialing database reflecting all in-network providers and a database to track status of practitioner’s or facilities undergoing the direct credentialing or re-credentialing process

Establishes individual files for each applicant containing the application, documents to support primary source verification and all other

Malpractice enrollment and maintenance for all providers

Ensures completion of provider credentialing applications

Contacts providers to request updates to licenses and documents; assist in renewals with expiration dates

Follows up with insurance companies to ensure timely enrollment and re- enrollment for billing purposes

Maintains multiple databases: online credentialing database (CAQH); provider information database, as well as all internal provider and insurance databases

Assists in collection of data to perform credentialing, re-credentialing, and privileging

Demonstrates and promotes a work culture committed to UVVC’s Core Values: understanding, nurturing, ingenuity, trust, excellence, and diversity

Demonstrates behaviors that are consistent with UVVC’s Standards of Conduct as outlined in our Employee Handbook

Maintains the confidentiality and security of Protected Health Information (PHI) in accordance with UVVC policies, the Health Insurance Portability and Accountability Act (HIPAA), and other applicable laws and regulations. PHI is a top priority of our organization

Other related duties as assigned

Qualification

Credentialing experienceCPCS CertificationMedicaid enrollmentHospital privilegingManaged care experienceDependabilityLeadership skillsWritten communicationVerbal communicationAttention to detailOrganizational skillsConfidentiality

Required

HS Diploma or GED required

5+ years' credentialing experience required

Knowledge and understanding of the provider-IPA-payer relationship

Experience with professional liability insurance applications

Experience managing and leading direct reports

Ability to maintain deadlines and multi-task

Excellent written and verbal communication skills

Extreme attention to detail and strong organization skills

Must be able to demonstrate extreme confidentiality in the role

Dependable; able to meet reliable attendance and punctuality standards

Preferred

Bachelor's degree preferred

Certified Provider Credentialing Specialist (CPCS) Certification preferred

Previous experience with Medicaid enrollment, hospital privileging, and managed care

Benefits

Competitive compensation package

Outstanding work life balance

Health, vision, and dental benefits

401K plan match

Life insurance (100% company paid)

PTO and paid holidays

Company

United Vein & Vascular Centers

United Vein & Vascular Centers is a fast-growing healthcare company headquartered in Tampa, Florida, and currently has clinics throughout the country.

Founded in 2015

Tampa, Florida, USA

201-500 employees