Credentialing Operations Supervisor

2 weeks ago

Hillsboro, United States Virginia Garcia Memorial Health Center and Foundation Full time

About Us: At Virginia Garcia Memorial Health Center, we embrace diversity and are committed to serving populations that have been historically marginalized. Our mission focuses on delivering high-quality, culturally sensitive healthcare to low-income residents, particularly seasonal and migrant farm workers.

Position Overview: The Credentialing Operations Supervisor is tasked with leading the Credentialing Department and managing the Credentialing team. This role involves the development and implementation of policies and procedures, as well as auditing workflows to ensure compliance with regulations and enhance operational efficiency.

Key Responsibilities:

  • Act as the primary credentialing liaison for internal and external credentialing entities, fostering positive relationships.
  • Oversee the department's budget and resource allocation.
  • Identify software and vendor requirements to support credentialing processes.
  • Ensure adequate staffing levels are maintained within the department.
  • Create training materials and process documentation for the team.
  • Conduct credentialing, privileging, and re-credentialing for licensed practitioners.
  • Verify credentials in accordance with organizational policies and federal regulations.
  • Prepare and present credentialing information to the Board of Directors for decision-making.
  • Ensure timely processing of credentialing for commercial insurers and government programs.
  • Maintain confidential credentialing records and databases, ensuring accuracy and compliance.
  • Collaborate with various departments to address credentialing issues and enhance service delivery.
  • Provide training and support to Credentialing Specialists to develop their skills.
  • Coordinate and lead departmental meetings and initiatives.
  • Stay informed about current credentialing regulations and ensure adherence.
  • Manage credentialing audits and compliance with external agencies.
  • Supervise and mentor Credentialing staff, promoting a culture of excellence and accountability.

Qualifications:

  • Bachelor's degree required.
  • Minimum of 5 years in a management role within credentialing.
  • 5 years of experience in credentialing processes.
  • Credentialing certification preferred, with a requirement to obtain within a specified timeframe.

Skills and Attributes:

  • Exceptional organizational and communication skills.
  • Ability to work independently and manage multiple priorities.
  • Strong problem-solving capabilities and attention to detail.
  • Proficiency in Microsoft Office applications.
  • Commitment to diversity and working with individuals from various backgrounds.

Work Environment: This position is primarily office-based, requiring the use of standard office equipment and software.

Equal Opportunity Employer: Virginia Garcia Memorial Health Center is an equal opportunity employer, committed to inclusivity and diversity in the workplace.

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