Penn Medicine • Philadelphia, PA 19133
Job #2679294691
Description
Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.
Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?
Senior Credentials Manager
Supports the AVP in drafting the annual Office of Medical Affairs strategic plan/goals and budgets and proposes updates as necessary; manages strategic initiatives in order to keep on time and on budget, and provides AVP with regular updates.
Directly manages CVO Credentialing Operations Supervisor/Manager and all credentials staff not reporting directly to the CVO Credentialing Operations Supervisor/Manager; includes work allocation, training, promotion, enforcement of internal procedures and controls, and problem resolution; evaluates performance and makes recommendations for personnel actions; motivates employees to achieve peak productivity and performance.
Holds primary responsibility for CVO's ongoing NCQA certification including but not limited to leading the biannual survey effort. Supports (Sr) Compliance Analyst with regulatory surveys/audits, and ensures compliance with TJC, DoH, CMS & NCQA standards.
Manages and reports operational metrics. Monitors turnaround times for processing of credentials applications and has overall accountability for focus on delivery of a high quality product, with the greatest efficiency, in the least amount of time. Accountabilities include but are not limited to:
Responsible for compliance with accrediting organization requirements and each of the Penn Medicine medical staff bylaws & accompanying manuals and credentials-related policies, development and review of CVO Operating policies and procedures, Managed Care Delegated Credentialing policies and procedures; develops, recommends, and/or implements changes, revisions, and enhancements as appropriate to current operating environment.
Responsible for maintaining strong customer relationships with leaders and staff at Penn Medicine hospitals, ensuring that they understand their role in the credentialing process and that their providers are credentialed and privileged to meet their requested start dates to the maximum extent possible.
Leads credentialing team in designing credentialing and privileging processes and in prioritizing and assigning resources devoted to process improvement, ensuring an appropriate level of quality control over credentialing and privileging work product.
Coordinates provider privilege approval with the Penn Medicine hospital Medical Staff Offices.
Works with OMA Managers to ensure that all CVO and hospital MSO staff have the necessary and appropriate training to be successful in their work.
Serves as senior credentialing representative to outward facing customers, both within and outside of Penn Medicine.
Performs duties in accordance with Penn Medicine and entity values, policies, and procedures.
Other duties as assigned to support the unit, department, entity, and health system organization.
NAMSS certification (CPCS and/or CPMSM)- within one year of employment (Preferred).
Bachelor's degree, preferably in business, information management, health administration or related field (Required).
7+ years of experience with hospital credentialing and/or 'delegated credentialing experience' (Required).
Master's degree, preferably in business, information management, health administration, or related field (Preferred).
Skills & Abilities:
Must have the ability to maintain information in a confidential manner in accordance with all regulatory requirements
Must be able to work effectively as a team leader, build effective teams, and drive employee engagement
Must be able to meet deadlines and conduct operations within budget
Must be able to exercise good judgment when escalating issues
Strong verbal and written communication skills to enable sufficient, timely, and effective communications with providers and external contacts
Proficient in computers and computer software, including but not limited to, database management, spreadsheet and word processing applications.
Proficiency in Microsoft Office Suite.
We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.
Live Your Life's Work
We are an Equal Opportunity and Affirmative Action employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.
REQNUMBER: UPHS-INFOR-216241
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