Group Credentialing Supervisor

Overview

Fast Pace Health strives to provide a best in class patient experience in every interaction. We are seeking a highly-skilled, experienced Group Credentialing Supervisor to join our growing team. Our ideal candidate will be deeply committed to nurturing our Fast Pace mission of teamwork, communication, empowerment and quality care in a friendly and encouraging environment.

Fast Pace Health aims to push for a new vision of healthcare in rural communities that will consist of an array of different services. We are changing the delivery of healthcare in these rural areas by integrating excellent patient care, education, accessibility, and community service, in a way that puts the patient’s needs first and improves the health status of our communities.

Responsibilities

In a way, that best supports our values, the individual is responsible for overseeing the daily activities of credentialing and payor enrollment processes for Fast Pace. The Credentialing Supervisor will play an important role in leading, coordinating, monitoring, and maintaining the credentialing and re-credentialing process. The Group Credentialing Supervisor will lead and manage the credentialing process as part of the onboarding and payer enrollment process for providers for all applicable states and locations. The Credentialing Supervisor ensures interpretation and compliance with the appropriate accrediting and regulatory agencies, while developing and maintaining a working knowledge of the statues and laws relating to credentialing and payor enrollment. The Group Credentialing Supervisor will take the Supervisor of organizing the team, assigning projects, and meeting deadlines.

Below, we have provided a high level view of what the role entails, with the complete job description discussed in detail during our interviewing process.

• Responsible for learning the aspects of compliance in the company by completing all mandatory compliance training.
• Lead and manage the Group credentialing process for Fast Pace and all affiliated entities.
• Direct a team to complete and assist in credentialing process to meet all goals and objectives.
• Obtains, verifies, and analyzes all required information pertinent to internal and external
• Credentialing.
• Organizes the credentialing process to meet required timelines.
• Report and resolve issues that arise from credentialing projects.
• Educates and supports clinicians in completing the credentialing process.
• Interfaces with health plan contacts to understand and support the credentialing
• application and completion process.
• Supports company processes to assure licensure and certification are maintained.
• Supports company processes for state regulatory requirements for physicians, nurse
• practitioners, physician assistants and other providers.
• Participates with the team to implement and adhere to policies, procedures, and systems to ensure timely data entry and enrollments in current Practice Management system.
• Ensures adherence to objectives, operating policies and procedures, and strategic action plans for achieving goals. Ability to track and report on credentialing key metrics monthly, quarterly, and as needed.
• Collaborates with Manager of Credentialing to create new processes and procedures as needed to improve overall claims escalation process.
• Responsible for managing a team of credentialing specialists, including conducting performance reviews, handling human resource concerns, PTO requests, and any other aspects related to HR as part of managing staff.
• Ensure adherence to objectives, operating policies and procedures, and strategic action plans for achieving goals.
• Recognizes strong individual and team performance in support of our values and company goals.
• Interviews candidates for positions that report to the Group Credentialing Supervisor as necessary.
• Responsible for overseeing training for positions that report to the Group Credentialing Supervisor.
• Responsible for overseeing performance and any related counseling of positions that report to the Supervisor, up to and including recommendation for termination of employment.
• Responsible for employees adhering to Standards of Operation, Core Values, and all other company policies.
• Responsible for overseeing annual review process for positions that report to the Group Credentialing Supervisor.
• The ability to provide training to positions that report to the Group Credentialing Supervisor on Company Standards of operations.
• The ability to provide ongoing monitoring of standards by conducting standards testing on positions that report to the Group Credentialing Supervisor.
• Ability to use computer systems including but not limited to Word, Excel, and credentialing software.
• The ability to perform the physical, use of senses, cognitive, and environmental functions of the position, as specified on the physical demands.
• The ability to build and maintain confidence and credibility with all clients and employees.
• The ability to maintain friendly, cordial relations with all clients and employees; maintain a positive work atmosphere by acting and communicating in a manner that results in a positive work relationship with customers, co-workers and managers.
• Ability to comply with Company Standards of Operations.
• Ability to adhere to the Core Values of the Company, of teamwork, communication, empowerment, quality of care, and friendliness.

Qualifications

• Previous experience in credentialing of physicians, nurse practitioners, or physician assistants (minimum of 2 years preferred)

• Associate’s or Bachelor’s Degree in healthcare or business administration (preferred but not required)
• Experience in use of the Council for Affordable Quality Healthcare (CAQH), Universal Provider Data source (UPD) for credentialing support.
• Ability to use computer systems including but not limited to Word, Excel, and credentialing software
• Excellent organizational skills
• Strong customer service approach
• Attention to detail
• Ability to work independently