Top 97183 Document manager Jobs

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- Health insurance
Quick Apply
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Credentialing Manager

Confidential
Miami, FL

Quick Apply

Job Details

Full-time

Benefits

Disability insurance
Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance
Life insurance

Qualifications

Staff supervision
Healthcare staff management
Operations management
Team leadership
HIPAA
Employee relationship building
Database management
Bachelor's degree
Data management
Attention to detail
NCQA standards
Bachelor of Business Administration
Medicaid regulations
Business Administration
Business
General management

Full Job Description

The Credentialing Manager is a key corporate functional role for the organization that administers credentialing and provider enrollment services. This role is responsible for managing and monitoring processes and procedures that support credentialing, re-credentialing, expirable data management, and ensuring compliance with state and federal regulations.

Strategic Leadership

Analyze and implement process improvements to enhance credentialing efficiency.
Serve as a primary resource to employees with regards to issues, interpretation and application and department policies and procedures.
Conduct periodic audits of credentialing files and staff work product.

Operational Excellence

Coordinates with practice management, licensing agencies, and insurance carriers to complete credentialing and re-credentialing applications.
Develop and implement departmental controls and procedures to ensure accuracy and efficiency.
Ensure compliance with the credentialing requirements of the health plan partners and related regulatory and accrediting agency requirements.

Collaboration and Reporting

Collaborate with leadership on policy development and standardization of criteria/processes across the organization.
Monitor external credential databases to ensure data is updated and ready for quick retrieval and use by interested parties.
Oversee processes and review all reports related to adverse actions such as sanctions, licensure actions or limitations, and credentialing-related complaints.

Compliance

Ensure compliance with state and federal regulations related to the delivery and documentation of patient care.
Monitor the renewal of licenses and other documents subject to expiration, and ensure updates are forwarded to facilities and healthcare partners as renewals are received.
Develops and provides regular reports and presentations on the operations and progress of credentialing functions, including activity related to approvals, denials, and appeals.

Team Development

Direct the output of a team of employees and provide ongoing training as needed regarding new guidelines or updated processes/policies.
Foster a positive, collaborative work environment that promotes teamwork and cross-functional cooperation.

KNOWLEDGE, SKILLS & ABILITIES

Excellent communication skills (written and verbal), as well as exceptional people skills.
Exceptional leadership abilities, a problem-solving mindset, and a focus on team engagement and transparency.
Strong understanding and use of web-based credentialing applications.
Ability to manage multiple priorities in a fast-paced environment while working professionally, courteously, collaboratively, and cooperatively as part of a team.
Ability to build partnerships with management, staff, and stakeholders to achieve department and organizational goals and objectives.
Attention to detail and ability to analyze large amounts of data.
Proficient with Microsoft Office Suite, database administration, and scanning applications.

EDUCATION & EXPERIENCE

Minimum of 5 years of credentialing experience with at least 2 years in a supervisory role.
Bachelor's degree in business administration or a healthcare-related field.
Master's degree and/or relevant field preferred.
Database management skills include querying, reporting, and document generation.

SUPERVISORY RESPONSIBILITIES

Manage the Credentialing process and its associates.

WORKING CONDITIONS

General office working conditions.

Job Type: Full-time

Benefits:

401(k)
Dental insurance
Disability insurance
Health insurance
Life insurance
Paid time off
Vision insurance

Work Location: In person

Quick Apply

Refine Your Search

document manager jobs

Credentialing Manager

Document Control and MQA Manager

Documentation Control Manager

Billing Manager

Project Manager Hazardous Waste Disposal

Project Manager

Remote Document Review Project Manager

Contract Manager

Proposal Manager

Project Manager I

Project Manager - US Remote

Proposal Manager - Infrastructure North America - Remote

Contract Manager

Payments Implementation Manager

Document Control Manager

Manager, GQC Support

Project Manager

Project Manager - Records & Compliance

Document Processing Department Manager

Document Control Manager

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