Credentialing Data Manager
The Credentialing Data Manager will assist with the planning, implementation and success of the Business
infrastructure for credentialing system applications and related systems that support the physician and
provider’s medical staff credentialing and onboarding process. Assists in software system
implementations, upgrades and maintenance. Assist in implementing policies and protocols to ensure
deployment of best practices. Assist with planning, organizing and implementing education and training
programs to meet the strategic goals of the department. The position will report to the Senior Director of
the Centralized Verification Office (CVO).
Job Roles & Responsibilities:
- Manage projects from initiation to completion, as needed, to develop process improvement or data integrity initiatives.
- Create and implement project plans.
- Provide subject matter expertise on team products and processes and CVO credentialing data systems.
- Identify and reports systemic or recurring problems. Presents process improvement plan to eliminate issues/impediments to delivering service excellence and meeting organizational and department goals/established metrics.
- Participate in the implementation of new programs and services related to CVO operations.
- Maintains standardized data integrity rules.
- Coordinates the management of the expirables process to ensure all clinical provider licenses and certificates remain current, ensuring appropriate notification prior to expiration.
- Develops and reports turnaround times for processing of credentials applications, with continued focus on delivery of a high quality product, with the greatest efficiency, in the least amount of time.
- Participates in development and review of CVO Operating policies and procedures, Managed Care
- Delegated Credentialing policies and procedures.
- Coordinates the management of the electronic credentials application, to ensure distribution, receipt, processing, and timely delivery to health system entity.
- Identify process improvement opportunities to decrease cost, improve quality and increase efficiency within the department and streamlining effective credentialing processes across multiple markets.
- Drive improvement in provider satisfaction through operational efficiencies.
- Performs miscellaneous job-related duties as assigned.
Knowledge, Skills & Abilities:
- Bachelor's Degree or equivalent work experience.
- Three to five years medical staff management and credentialing experience.
- National Association of Medical Staff Specialists (NAMSS) Certification, CPMSM or CPCS, preferred.
- Ability to investigate and analyze information and draw conclusions.
- Database management skills.
- Knowledge of medical credentialing and privileging procedures and standards.
- Knowledge of medical staff policies, regulations, and bylaws and the legal environment within which they
- Ability to communicate effectively, both orally and in writing.
- Ability to foster a cooperative work environment.
- Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies.