Director of Credentialing-Remote

QGenda

Location: Burlington, Vermont

Type: Full Time

Education: No Ed Requirements

Experience: 5 - 10 Years

The Director of Credentialing at QGenda is responsible for providing mentorship and direction to the Credentialing Team and other departments within the QGenda organization. This person will maintain relationships with external customers, internal leaders, and work closely with the product development team to enhance the Credentialing platform.

 

Responsibilities:

  • Maintain an NCQA compliant program at all times.
  • Establish department policies and procedures consistent with NCQA standards.
  • Provide leadership and direct supervision to the Credentialing Team and serves as Subject Matter Expert (SME) to leadership and other departments in the organization.
  • Develop and implement key performance indicator reporting to assess the productivity and accuracy of the credentialing teams performance. Provide final oversight and approval on the quality of work produced by the team to ensure established processes and procedures are followed. Work to meet monthly productivity goals and expectations.
  • Responsible for the management of the credentialing team to include staff productivity, hours worked, and team responsibilities. Ensure the quantity and quality of work meets expectations.
  • Recruit, hire, train, assist, coach, and mentor new staff on department and Company specific processes, policies, and procedures.
  • Identify team opportunities and demonstrate the ability to positively impact results in team engagement, quality and retention.
  • Conduct regularly scheduled one-on-one/side by side interactions and developmental meetings with direct and indirect reports, designed to enhance awareness, support, expand knowledge and increase accountability.
  • Manage relationships with external customers to ensure SLA’s, goals and terms of agreements are measured, managed and achieved.
  • Work with sales leaders to research, clarify, and resolve client and provider concerns and inquiries.
  • Work closely with the software product development team to provide useful input on usability of our internally developed credentialing platform. Recommend improvements and enhancements to the product.

 

Knowledge, Skills, and Abilities:

  • Demonstrates knowledge in financial planning and budgeting, understanding the role of each in the organization’s overall financial picture.
  • Familiar with NCQA standards and audits and surveys

 

Requirements:

  • 7 + years CVO/Medical Staff credentialing experience is required. Payer enrollment experience is a strong plus.
  • 5+ years managing and leading a team of credentialing specialists is required
  • CPCS certification or be able to obtain it within 6 months of employment

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