Manager, Credentialing

4 weeks ago

Atlanta, United States NextGen Healthcare Full time

Job Description:

The Manager of Credentialing is responsible for managing day-to-day operations and credentialing staff that processes and handles credentialing and re-credentialing applications and other credentialing-related documentation for medical providers.
  • Manages day-to-day operational requirements, ensuring workflow instructions are followed and production and performance goals are met.
  • Ensure compliance with established credentialing protocols while ensuring Customer Satisfaction.
  • Oversees the maintenance and upkeep of all provider certifications and other areas related to provider credentialing.
  • Serves as a point person for VOC Survey results and reports results out to senior management and credentialing staff.
  • Prepare and maintain regular departmental reporting and credentialing database details as required by senior management.
  • Make appropriate recommendations to senior management for staffing modifications.
  • Suggests policy and procedure improvements to ensure the applications are properly verified and uploaded accurately into the database in a timely manner.
  • Maintains both internal and external Customer relationships and manages expectations related to the performance of deliverables.
  • Completes workflows, staff development and training required for department success.
  • Perform other duties that support the overall objective of the position.
Education Required:
  • Bachelor's Degree or equivalent work experience.
  • Or, any combination of education and experience which would provide the required qualifications for the position.

Experience Required:
  • 5 years' Credentialing or related area as an individual contributor with 1 to 3 years supervisory experience in a Credentialing or related area.
Knowledge, Skills & Abilities:
  • Knowledge of: Knowledge of credentialing principles, best practices, data analytics tools and processes. Knowledge of general accounting principles and best practice. Proficient in Microsoft Office.
  • Skill in: Analytical and problem solving skills. Strong attention to detail. Excellent communication skills (oral, written). Excellent presentation and negotiation skills. Leadership and mentoring skills.
  • Ability to: Ability to manage multiple projects and people simultaneously with wisdom to prioritize appropriately and efficiently for best outcome. Ability to lead a team and maintain relationships.

The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is intended to provide guidelines for job expectations and the employee's ability to perform the position described. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate. This document does not represent a contract of employment, and the company reserves the right to change this job description and/or assign tasks for the employee to perform, as the company may deem appropriate.

NextGen Healthcare is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

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