Credentialing and Compliance Director

2 days ago


Mountlake Terrace, Washington, United States Mindful Support Services Full time
About the Role

Mindful Support Services is seeking a highly skilled Credentialing and Compliance Manager to join our team. As a key member of our operations team, you will be responsible for the day-to-day management of the Credentialing and Compliance department.

Key Responsibilities
  • Oversee all aspects of credentialing, including individual credentialing applications and delegated credentialing
  • Provide daily direction and priorities to Credentialing Specialists
  • Develop, monitor, coach, and manage staff to ensure the development of employees through training, setting clear expectations, providing constructive feedback, and completing regular performance evaluations
  • Identify and resolve credentialing issues through regular auditing and reporting
  • Maintain detailed knowledge of current government and third-party payor-specific regulations and ensure the organization is compliant with these requirements
  • Research and maintain business licenses for each city and state for providers
  • Lead annual business compliance audit for all providers and attestation reviews
  • Actively identify, initiate, drive, and participate in quality improvement initiatives in accordance with the organization's mission and strategic goals, federal and state laws and regulations, and delegated credentialing standards
  • Create, maintain, and update department resources
  • Collaborate with other departments to research and resolve credentialing or compliance escalations
Requirements
  • 3+ years of multi-state provider credentialing experience
  • 2+ years of leadership experience
  • Strong project management skills
  • Extensive knowledge of state and federal healthcare legislation, credentialing and contracting protocol, and NCQA (National Committee on Quality Assurance) requirements
  • Certified Provider Credentialing Specialist (CPCS) certification preferred
  • Prior credentialing software experience preferred
  • Prior experience and success in a fast-growing organization preferred
Core Competencies
  • Strong sense of urgency to resolve escalated issues and concerns
  • Strong verbal and written communication
  • Demonstrated critical thinking and problem-solving skills
  • Strong organization and time management skills
  • Ability to work effectively both independently and as a team
  • Proficient with Microsoft Office Suite, particularly Excel and SharePoint
Work Environment
  • The position is a hybrid position based at Mindful Support Services' Headquarters
  • This role requires prolonged periods of sitting at a desk and working on a computer
Benefits
  • 75% employer-covered Health, Dental & Vision benefits plan
  • 401(k) savings plan with employer matching upon eligibility
  • 8 paid holidays
  • 15 PTO days accrued annually in the first year
  • Professional and career development opportunities
  • Compensation evaluated with opportunities for advancement
Job Type

Full-time

Pay

$100,000.00 per year


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