HEALTH CONNECT AMERICA, INC
Credentialing Director
HEALTH CONNECT AMERICA, INC, Franklin, Tennessee, us, 37068
Join Our Impactful Team at Health Connect America!
Before you get started on your journey, take some time to learn more about us.
Health Connect America
and its brands are leaders in providing mental and behavioral health services to children, families, and adults across the nation. We provide our services directly to those in need whether that be within a person's home, their community, or in one of our office settings. HCA is honored to be a part of the communities we serve and the clients we walk alongside as they embark on a journey to self-improvement and more fulfilling lives. At
Health Connect America , we are dedicated to making meaningful connections every day through creating quality, affordable opportunities for individuals and families to achieve their greatest potential in a safe, positive living environment.
Our Brands
Responsibilities:The Credentialing Manager plays an integral role within healthcare organizations, overseeing the process that allows medical professionals to practice at healthcare facilities or with insurance networks. This position involves managing the verification of qualifications, certifications, and licenses of healthcare providers to ensure they meet the necessary standards for providing care. By maintaining accurate and up-to-date records, the Credentialing Manager supports the seamless operation of healthcare services, ensuring that only qualified professionals are part of the team. This role requires a meticulous attention to detail and a strong understanding of regulatory compliance, as it serves to uphold the integrity and quality of healthcare delivery.
What Will I Be Doing?
Develop and implement policies and procedures for credentialing and recredentialing healthcare providers ensuring compliance with national accreditation standards, state and federal regulations, and payer requirements.
Manage the primary source verification of education, training, board certification, work history, and licensure of healthcare providers.
Facilitate the resolution of discrepancies or concerns regarding applicants’ credentials, working closely with medical staff leadership and healthcare providers.
Liaise with external agencies, including insurance carriers and regulatory bodies, to ensure the timely sharing of credentialing information and compliance with external standards.
Manage the credentialing process from initial application through re-credentialing, including primary source verification, background checks, and review of licensure, certifications, education, and work history.
Responsible for integration of newly acquired entities, including software and staff.
Collaborate with internal departments, such as Human Resources, and Quality and Compliance to ensure alignment of credentialing processes with organizational goals and objectives.
Maintain accurate and up-to-date credential files and databases, ensuring confidentiality and security of sensitive information.
Serve as the primary point of contact for credentialing inquiries from healthcare providers, staff, and external stakeholders, providing timely and accurate responses.
Monitor and evaluate the performance of credentialing staff, providing guidance, training, and support as needed to ensure high-quality and efficient credentialing processes.
Stay informed about changes in credentialing requirements, regulations, and industry trends, and make recommendations for process improvements and enhancements.
Prepare and submit reports on credentialing activities, compliance metrics, and performance indicators to senior management and regulatory agencies as required.
Participate in audits, surveys, and accreditation reviews related to credentialing, providing documentation, and supporting evidence as needed.
Represent the organization in meetings, conferences, and industry events related to credentialing and provider enrollment.
Qualifications:
Associates Degree (Bachelor’s Degree preferred) with at least 5 years of experience in credentialing.
Be Well with HCA:
We recognize the importance of self-care and work/life balance.
We offer flexibility in scheduling and provide all employees access to our Employee Assistance Program (EAP), which includes 8 mental health counseling sessions annually.
Full-time HCA employees enjoy paid time off, paid holidays, and a comprehensive benefits package that includes medical, dental, vision, and other voluntary insurance products.
Additional benefits include:
Access to a Health Navigator
Health Savings Account with company contribution
Dependent Daycare Flexible Spending Account
Health Reimbursement Account
401(k) Retirement Plan
Benefits Hub
Tickets at Work
Join a team where your contributions truly make a difference in the lives of others. Apply now to be part of our dynamic and supportive community at Health Connect America!
Employment at Health Connect America and its companies is contingent upon meeting the requirements of a comprehensive background investigation prior to joining our team.
Health Connect America
and its companies are an Equal Opportunity Employer and consider applicants for employment without regard to race, color, religion, sex, orientation, national origin, age, disability, genetics, or any other basis forbidden under federal, state, or local law. For more information on Equal Opportunity, please click here
Equal Employment Opportunity Posters
#J-18808-Ljbffr
Before you get started on your journey, take some time to learn more about us.
Health Connect America
and its brands are leaders in providing mental and behavioral health services to children, families, and adults across the nation. We provide our services directly to those in need whether that be within a person's home, their community, or in one of our office settings. HCA is honored to be a part of the communities we serve and the clients we walk alongside as they embark on a journey to self-improvement and more fulfilling lives. At
Health Connect America , we are dedicated to making meaningful connections every day through creating quality, affordable opportunities for individuals and families to achieve their greatest potential in a safe, positive living environment.
Our Brands
Responsibilities:The Credentialing Manager plays an integral role within healthcare organizations, overseeing the process that allows medical professionals to practice at healthcare facilities or with insurance networks. This position involves managing the verification of qualifications, certifications, and licenses of healthcare providers to ensure they meet the necessary standards for providing care. By maintaining accurate and up-to-date records, the Credentialing Manager supports the seamless operation of healthcare services, ensuring that only qualified professionals are part of the team. This role requires a meticulous attention to detail and a strong understanding of regulatory compliance, as it serves to uphold the integrity and quality of healthcare delivery.
What Will I Be Doing?
Develop and implement policies and procedures for credentialing and recredentialing healthcare providers ensuring compliance with national accreditation standards, state and federal regulations, and payer requirements.
Manage the primary source verification of education, training, board certification, work history, and licensure of healthcare providers.
Facilitate the resolution of discrepancies or concerns regarding applicants’ credentials, working closely with medical staff leadership and healthcare providers.
Liaise with external agencies, including insurance carriers and regulatory bodies, to ensure the timely sharing of credentialing information and compliance with external standards.
Manage the credentialing process from initial application through re-credentialing, including primary source verification, background checks, and review of licensure, certifications, education, and work history.
Responsible for integration of newly acquired entities, including software and staff.
Collaborate with internal departments, such as Human Resources, and Quality and Compliance to ensure alignment of credentialing processes with organizational goals and objectives.
Maintain accurate and up-to-date credential files and databases, ensuring confidentiality and security of sensitive information.
Serve as the primary point of contact for credentialing inquiries from healthcare providers, staff, and external stakeholders, providing timely and accurate responses.
Monitor and evaluate the performance of credentialing staff, providing guidance, training, and support as needed to ensure high-quality and efficient credentialing processes.
Stay informed about changes in credentialing requirements, regulations, and industry trends, and make recommendations for process improvements and enhancements.
Prepare and submit reports on credentialing activities, compliance metrics, and performance indicators to senior management and regulatory agencies as required.
Participate in audits, surveys, and accreditation reviews related to credentialing, providing documentation, and supporting evidence as needed.
Represent the organization in meetings, conferences, and industry events related to credentialing and provider enrollment.
Qualifications:
Associates Degree (Bachelor’s Degree preferred) with at least 5 years of experience in credentialing.
Be Well with HCA:
We recognize the importance of self-care and work/life balance.
We offer flexibility in scheduling and provide all employees access to our Employee Assistance Program (EAP), which includes 8 mental health counseling sessions annually.
Full-time HCA employees enjoy paid time off, paid holidays, and a comprehensive benefits package that includes medical, dental, vision, and other voluntary insurance products.
Additional benefits include:
Access to a Health Navigator
Health Savings Account with company contribution
Dependent Daycare Flexible Spending Account
Health Reimbursement Account
401(k) Retirement Plan
Benefits Hub
Tickets at Work
Join a team where your contributions truly make a difference in the lives of others. Apply now to be part of our dynamic and supportive community at Health Connect America!
Employment at Health Connect America and its companies is contingent upon meeting the requirements of a comprehensive background investigation prior to joining our team.
Health Connect America
and its companies are an Equal Opportunity Employer and consider applicants for employment without regard to race, color, religion, sex, orientation, national origin, age, disability, genetics, or any other basis forbidden under federal, state, or local law. For more information on Equal Opportunity, please click here
Equal Employment Opportunity Posters
#J-18808-Ljbffr