We are looking for a Credentialing Manager/Lead managing a Provider component for Ohio Department of Health.
1. Manages the central provider credentialing functions, special services for providers and field operations including provider liaison activities where applicable, provider training and outreach, materials development and provider recruitment for the Ohio Department of Health project.
2. Makes recommendations for operational changes to improve all functions for credentialing activities.
3. Oversees the administration of Primary Source Verifications of all provider due to credentials and re-credentialing.
4. Manages the scheduling and performance of staff to ensure compliance with contract requirements.
5. Manages processes by which provider calls are handled and ensures that questions and concerns are handled accurately, consistently, and on a timely basis.
6. Manages the development and maintenance of all training materials and arrangements for all trainings, and outreach/materials development staff.
7. Ensures that all regular and ad hoc reports are submitted accurately and on time.
8. Meets all standards established for this position.
9. Performs other duties as may be assigned by management.
Must have a minimum of three (3) years of experience in managing a Provider component of a State’s MMIS, or similar health care provider component, experience working with culturally, linguistically diverse, and disadvantaged populations in a courteous and effective manner; knowledge of quality assurance performance monitoring; excellent management and supervisory skills, including extensive experience with employee relations; computer literate; excellent organizational, written, and verbal communication skills; ability to perform comfortably in a fast-paced, deadline-oriented work environment; ability to successfully execute many complex tasks simultaneously; ability to work as a team member, as well as independently. Maintain regular cooperation and compliance with all regulatory, accrediting, and membership-based organizations; create and carry out various credentialing processes in relation to physicians, medical assistants, and various other healthcare professionals; ensure that all personnel and services adhere to facility and staff policies, department guidelines, regulations, and government laws.
Preferred qualifications include a Bachelor's degree from an accredited college or university in health, social services, or a related field.