Medical Staff Credentialing Manager jobs in Kansas
Medical Staff Credentialing Manager manages staff that process credentialing and recredentialing applications for health care providers. Oversees department operations to ensure compliance with all regulatory standards. Being a Medical Staff Credentialing Manager implements policies and procedures to ensure that applications are properly verified and accurately uploaded into an online credentialing database system. Analyzes reports on applications and credentialing status to identify trends and improve the credentialing process. Additionally, Medical Staff Credentialing Manager prepares files for the credentialing committee and may act as a liaison to state medical licensure boards regarding the status of license applications. Requires a bachelor's degree. May require Certified Provider Credentialing Specialist (CPCS). Typically reports to a director. The Medical Staff Credentialing Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. To be a Medical Staff Credentialing Manager typically requires 5 years experience in the related area as an individual contributor. 1 - 3 years supervisory experience may be required. Extensive knowledge of the function and department processes. (Copyright 2024 Salary.com)
Recently Added Medical Staff Credentialing Manager jobs
Manager Credentialing
- Blue Cross and Blue Shield of Kansas
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Topeka, KS
FULL_TIME
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Under the direction of the director of provider relations, the credentialing manager is responsible for managing credentialing initiatives according to state, federal and URAC standards. Manager, Credentialing will be responsible for developing and executing a comprehensive credentialing strategy that ensures regulatory compliance, qualifications, certifications, and efficiency of credentialing requirements are met by workforce to maintain regulatory compliance. This role requires a strong leader with a deep understanding of credentialing processes, regulatory standards, and a track record of driving excellence. This position is directly accountable for meeting all requirements by URAC, CMS, NTQL/Mental Health Parity Audits and delegated contracted services by TriWest for TRICARE, Healthy Blue for Medicaid, and all delegated oversight for specific provider entities who have entered into a delegated credentialing agreement. Failure to meet all expectations may result in penalties and/or risk of continuing an agreement for such program(s).
** This position is eligible to work hybrid (9 or more days a month onsite) in accordance with our Telecommuting Policy. Applicants must reside in Kansas or Missouri or be willing to relocate as a condition of employment.Are you ready to make a difference? Choose to work for one of the most trusted companies in Kansas.Why Join Us?- Lead and Inspire: Guide and mentor your team to achieve their full potential and success.
- Family Comes First: Total rewards package that promotes the idea of family first for all employees.
- Trust: Work for one of the most trusted companies in Kansas
- Stability: 80 years of commitment, compassion and community
- Inclusive Work Environment: We pride ourselves on fostering a diverse and inclusive workplace where everyone is valued and respected.
Compensation$93,760 – 111,000Exempt grade 17- Blue Cross and Blue Shield of Kansas offers excellent competitive compensation with the goal of retaining and growing talented team members. The salary range for this role is a good faith estimate, it is estimated based on what a successful candidate might be paid. All offers presented to candidates are carefully reviewed to ensure fair, equitable pay by offering competitive salaries that align with the individual's skills, education, experience, and training. The range may vary above or below the stated amounts.
What you’ll do- Meet all credentialing requirements for BCBSKS, URAC, TriWest, CMS, Healthy Blue, and delegated credentialing provider entities for all professional and institutional provider networks.
- Collaborate with other departments/units to ensure timely workflow of all required elements to determine the outcome of a provider.
- Work directly with external agencies to primary source verify all required licensing, malpractice, litigation, school and training, and other essential elements.
- Work directly with providers, licensing agencies, and attorneys to verify and discuss malpractice cases and/or license restrictions.
- Work directly with BCBSKS CMO, medical directors, and the corporate credentials committee to inform and resolve any provider issues involving a provider being credentialed or recredentialed.
- Effectively manages the credentialing or recredentialing of over 15,000 providers and must keep confidential records on each.
- Accountable for the completeness and accuracy of all credentialing files and must pass external audits.
- Accountable for the oversight and performance of all delegated credentialing arrangements with provider entities.
- Provide training to providers for the credentialing criteria and process.
- Must know all aspects of NQTL/Mental Health Parity and meet all requirements.
- Develop a clear and forward-thinking credentialing strategy aligned with organizational goals, industry best practices, and regulatory requirements.
- Design and implement streamlined and efficient credentialing processes that prioritize accuracy, compliance, and timely completion of applications.
- Collaborate with legal and compliance teams to address any regulatory changes or issues.
- Establish robust quality control measures to ensure the accuracy and completeness of employee credentialing data and documentation.
- Conduct regular audits and assessments to identify and rectify discrepancies or deficiencies in credentialing records.
What you need- Minimum of 5 years of experience in credentialing with a track record of progressively responsible roles.
Bonus if you have- Bachelor of Science in Nursing with current state license as a registered nurse preferred.
- Certified Provider Credentialing Specialist Certification, or able to obtain within one year.
- Proficiency in medical terminology preferred.
Benefits & Perks-
Base compensation is only one component of your competitive Total Rewards package
- Incentive pay program (EPIP)
- Health/Vision/Dental insurance
- 6 weeks paid parental leave for new mothers and fathers
- Fertility/Adoption assistance
- 2 weeks paid caregiver leave
- 5% 401(k) plan matching
- Tuition reimbursement
- Health & fitness benefits, discounts and resources
Posting Close DateJune 13, 2024Pay Rate TypeSalary - Just Posted
Credentialing & Quality Coord - Ambulatory Surgery
- Saint Joseph Medical Center
-
Overland Park, KS
FULL_TIME
- Credentialing & Quality Coord - Ambulatory Surgery Facility South Kansas City Surgery Center Location US-KS-Overland Park ID 2024-162270 Category Business Professional Position Type Part Time > 59 Shi...
- Just Posted
Credentialing & Quality Coord - Ambulatory Surgery
- Providence Medical Center
-
Overland Park, KS
PART_TIME
- OverviewAt South Kansas City Surgery Center, our dedicated team of professionals is committed to our core values of quality, compassion, and community. Affiliated with St. Joseph Medical Center, South...
- 1 Day Ago
Interim Leadership Manager / Director Medical Staff Manager
- Aya Healthcare
-
Abilene, KS
FULL_TIME,CONTRACTOR,TEMPORARY
- Aya Healthcare has an immediate opening for the following position: Medical Staff Manager Manager / Director in Abilene, Kansas. This is a 13-week contract position that requires at least one year of ...
- 11 Days Ago
Helpdesk Manager
- Remote Staff
-
Home, KS
FULL_TIME
- JO 13684 | Helpdesk ManagerStatus: Full-time / 40 hours per weekSchedule: 7:00 AM – 4:00 PM Manila TimeWhy choose Remote Staff?100% Work from Home. No office-based setups. Manage your time efficiently...
- 11 Days Ago
Business Development Manager
- Kwik Staff
-
Topeka, KS
FULL_TIME
- ```Duties```- Develop and implement strategic business development plans to achieve company goals and objectives.- Identify and pursue new business opportunities through market research, networking, a...
- 20 Days Ago
Medical Staff Credentialing Manager jobs at Popular Companies
Lead, Customer Success (local, in office)
- Heuristic Solutions
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Arlington, VA
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Credentialing Manager
- PsychPlus
-
Houston, TX
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Credentialing Manager
- Mindful Support Services
-
Mountlake Terrace, WA
- About the Role: The Credentialing Manager is responsible for the day-to-day management of the Credentialing and Complian...
- 6/10/2024 12:00:00 AM
CREDENTIALING MANAGER
- USA Clinics Group
-
Chicago, IL
- At USA Clinics Group, we use our expertise to provide the best possible service for our patients. Our team members are p...
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Project Coordinator
- Northland Controls
-
Austin, TX
- Job Details Job Location Austin, Texas - Austin, TX Description Job Description JOB MISSION The mission of the Project S...
- 6/10/2024 12:00:00 AM
CyberArk Engineer
- Veracity Software Inc
-
Charlotte, NC
- Job Title: CyberArk Engineer Duration: 12 Months Location: Charlotte, NC – Hybrid Role W2 Candidates Only Job Descriptio...
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CyberArk Engineer
- REALCODERZ
-
Charlotte, NC
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Lead, Customer Success (local, in office)
- Heuristic Solutions
-
Arlington, VA
- Join a Growing Technology Team and an Awesome Customer Community! Do you... Enjoy simplifying complex concepts? Love bei...
- 6/7/2024 12:00:00 AM
About Kansas
Kansas /ˈkænzəs/ (listen) is a U.S. state in the Midwestern United States. Its capital is Topeka and its largest city is Wichita, with its most populated county being Johnson County. Kansas is bordered by Nebraska on the north; Missouri on the east; Oklahoma on the south; and Colorado on the west. Kansas is named after the Kansa Native American tribe, which inhabited the area. The tribe's name (natively kką:ze) is often said to mean "people of the (south) wind" although this was probably not the term's original meaning. For thousands of years, what is now Kansas was home to numerous and divers...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Staff Credentialing Manager jobs
$92,114 to $118,781
Most Popular Cities in Kansas for Medical Staff Credentialing Manager Jobs
What does a Medical Staff Credentialing Manager do?
Medical Staff Credentialing Manager in Cedar Rapids, IA
Medical Staff Services Coordinator - Credentialing - Full-Time (40hrs/wk), Days - Corporate Services - Glendale, WI.
January 14, 2020
Medical Staff Credentialing Manager in Tampa, FL
Patient safety is the name of the game in credentialing.
January 25, 2020
Medical Staff Credentialing Manager in Nassau, NY
There are several reasons why a commercial payer, such as a managed care organization or health plan, may consider delegating all or part of its credentialing activities to qualified business partners such as IPAs, PHOs, CVOs, medical societies, even other health plans.
December 17, 2019