Manager Credentialing
Lifespan Corporate Services - Providence, RI

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Description
: The Manager Credentialing reports to the Director Billing Patient Financial Services. Under general supervision and within Lifespan policies and procedures, is responsible for Lifespan credentialing operations and assists in the development of the overall strategy for creating a centralized process. Develops and integrates new technology to enhance this process. Provides direct management to professional support staff in administering all aspects of the credentialing services with a strong emphasis on the delivery of quality, efficiency and superior service. Implements the policies and standards to ensure that credentialing operations are in compliance with NCQA credentialing standards and any specific delegated credentialing requirements. Works with the Medical Staff offices at hospitals and other facilities as needed. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.

Qualifications
: Bachelor's degree in health services administration, or the equivalent previous experience in a provider network credentialing entity or an acute care facility Medical Staff Services environment.

Minimum of three year’s previous credentialing supervisory experience. Five years previous experience within a health insurance/HMO payer entity covering a wide geographical area and credentialing management experience preferred. Management skills including delegating, coaching, mentoring, and disciplining. Knowledge of credentialing principles for provider networks/payers. Intermediate computer skills, credentialing software and information systems knowledge; ability to generate management and production reports, documents and correspondence independently. Current knowledge of NCQA and Medicare credentialing standards and other regulatory requirements. Strong knowledge of medical terminology.

Supervisory responsibility for up to 10 FTEs.

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