Director, Credentialing in Latham, NY at Beacon Health Options

Date Posted: 6/5/2018

Job Snapshot

Job Description

About the Position:

The Director, Credentialing is responsible for the day-to-day operations and performance of all provider credentialing functions. The Director is the accountable one point-of-contact for all provider credentialing activity including inventory management, new business, audits, credentialing SME, staff leadership and development, budget, policy management, service level agreements and vendor relationships. 

Position Responsibilities:

  • Effectively lead the credentialing teams in the Woburn, Latham, and Cypress locations (and others to be determined in the future) as evidenced by reduced operating costs, increased provider satisfaction, compliance with internal, client, regulatory and accreditation standards, successful audits, and employee satisfaction and engagement.
  • Assure that credentialing specialists are meeting productivity and quality performance standards by holding supervisors accountable for their development and performance.
  • Assure the credentialing team is accountable to the Service Centers and Client Partnerships by meeting internal and external performance standards. Act as liaison and maintain productive working relationships with all Beacon departments, as well as with client health plans. Participate in monthly accountability reviews with internal customers (service centers, account teams, etc.)
  • Meet or exceed all budget targets.
  • Identify process improvement opportunities and successfully implement them.
  • Co-chair Beacon Health Options’ National Credentialing Committee.
  • Assure successful outcomes for NCQA and other credentialing surveys and audits.  Partner with Service Centers and Corporate Quality to assure ongoing involvement in the NCQA processes.
  • In partnership with Network Strategy and National Support, support and act as credentialing SME for provider network shared services transformational projects and drive successful implementation of these projects.
  • Other duties as assigned.

Position Requirements:

  • Education:  Bachelor’s degree in health or human services/administration preferred
  • Licenses: Certified Provider Credentialing Specialist (CPCS) preferred
  • Relevant Work Experience:  2 - 5 years management experience in a health care organization, managed care preferred. Provider network experience, particularly in credentialing. Customer service experience and experience in a production environment. Strong leadership characteristics and ability. Professional demeanor, strong written and oral communication skills, strong computer skills, and the ability to learn Beacon’s internal systems. Detail-oriented, analytical, highly organized and possessing problem-solving skills. Ability to manage varying job pressures, and meet deadlines and handle multiple tasks simultaneously with minimal supervision. Computer literacy and experience with Microsoft office programs (Outlook, Word, PowerPoint and Excel). Experience working with fax machines, copiers and other office equipment.

To Apply:

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Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment.  EOE/AA/M/F/Veterans/Disabled