Manager, Medical Affairs Internal Credentialing

Position Overview

The Internal Credentialing Manager is responsible for overseeing the day-to-day clinician Internal credentialing and Reappointment process to successful completion. Primary responsibilities include training Credentialing Coordinators, manage, and maintain policies and procedures, complete Array credentialing processes, and ensure the Internal Credentialing team activities are cost-effective and high-quality.

Job Responsibilities

• Oversee the day-to-day activities including leading, coordinating, monitoring, and maintaining the internal credentialing process
• Manage the Internal process for our OnDemand, AtHome, and Scheduled Care services lines
• Maintain policies and procedures associated with Internal activities; developing new policies as needed
• Run daily reports to assign inventory as necessary
• Ensures departmental guidelines are followed to support all Internal Credentialing policies and procedures including 40-day turnaround time
• Tracks the credentialing and enrollment application process to promote compliance, process enhancement, and efficiency
• Acts as a level of escalation for any real or suspected violation of the corporate compliance program, company policies and procedures, harassment, or other prohibited activities in accordance with the reporting policies of the company
• Makes leadership aware of any potential derogatory issues identified during the credentialing process and works in collaboration with practitioner to document/resolve the issue
• Conducts monthly reviews with staff members to review quality, production, attendance, and behavior status based on the KPI guidelines
• Performs annual reviews for direct reports to foster development
• Provides leadership team with weekly, monthly, quarterly, and annual reports identifying the process, concerns, and action plans for all applicants
• Develops trending reports to identify areas of opportunity, areas of success, and to determine if any other process enhancements are needed
• Train/coach the Credentialing Coordinators to improve professional knowledge and skills, using current technologies and streamlined processes
• Ensure compliance with re-credentialing and expirables requirements
• Manage the preparation and maintenance of reports necessary to carry out the functions of the department; prepare periodic reports (KPI’s) for management, as necessary or requested, to track strategic goal accomplishment

Job Requirements

• 5 years’ experience and knowledge of provider licensure, credentialing, and accreditation standards, including the functions, operation, and mission of the department
• 2 years’ people management and function supervision experience
• Strong knowledge base of Joint Commission and NCQA guidelines along with state licensing requirement standards
• Self-starter and solutions orientation with excellent written and spoken communication skills
• Outstanding interpersonal relationship-building and employee coaching and development skills
• Ability to prioritize, multitask, meet deadlines with accuracy and excellence
• Comfortable working with a remote team
• Excellent computer skills using MS Windows and Symplr

Logistics

• Remote Position, available immediately
• Reports to VP of Medical Affairs
• FLSA Status: exempt, salary
• The pay range for this role starts at $65,000. This information reflects the anticipated salary for this position using current national data.  The final offer will be determined based on an individual’s skills, experience, education, and other job-related factors permitted by law.

At Array we strongly value diversity and are committed to equal opportunity and non-discrimination in all policies and practices, including the area of employment.  We are proud to be an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, age, disability, Veteran status, gender identity or expression, marital status, genetic information, or any other legally protected status.

EOE M/V/F/D