Manager, Delegated Credentialing

Accounting + Finance United States


Description

Company: Oak Street Health

 

Title: Manager of Delegated Credentialing

Location: Remote; Treehouse

Role Description

The Delegated Credentialing Manager is responsible for supporting multiple specialty areas of business operations surrounding delegated credentialing, and will execute the strategic business plan as well as lead the day-to-day functions and staff, encompassing delegated provider oversight for diverse programs/projects. This position will work closely with our credentialing team to support implementation of delegated credentialing as well as the expansion, retention and compliance with our delegated contracts.  This involves front end work with new providers and states, ongoing credentialing, and back-end handling of any upcoming license & malpractice renewals or provider terminations / transitions. The scope will include oversight of the credentialing process for our over 700 provider practice across 25 states and growing.  The position will report to the Director of Credentialing.

  • Manages all aspects of the delegated credentialing process within their designated team to ensure accuracy, completeness, and timeliness of key credentialing activities.

  • Oversees the delegated credentialing process, from pre-delegation assessment to monthly file receipt and processing to annual audits

  • Ensures delegated credentialing program is compliant with the standards established by the National Committee for Quality Assurance (NCQA), the Centers for Medicare and Medicaid Services, and other regulatory agencies, as needed

  • Performs pre-delegated audits and annual assessment audits to ensure delegated entities are compliant with THP policies and procedures as well as all accreditation, regulatory, and governing entities

  • Prepares pre-delegated annual assessment audits including scheduling audits and sending pre and post audit letters and communications

  • Supports establishment of credentialing standards and analyzes workflows that promote best practices.

  • Champions innovation and implements performance management strategies as needed to optimize team member contributions

  • Direct managerial responsibilities including hiring, training, mentoring and coaching to all credentialing team members 

  • Cultivates positive interpersonal relationships with internal and external clients, medical services professionals, practitioners, ancillary staff and senior management.

  • Collaborates with Director and other key staff on management of an ongoing credentialing performance improvement initiatives

  • Partners with the Director to develop and implement long and short-term goals for the designated team.

  • Provides support to the Director for interpretation, development, and implementation of all systems and functions to ensure continuous compliance with all regulations.

  • Perform administrative and other duties as assigned

What are we looking for?

  • A bachelor's degree or minimum 5 years' credentialing work experience.

  • 2+ years in management/supervisory role.

  • Professional communication skills with both staff and executive levels

  • Attention to detail and strong organizational skills

  • Sense of urgency

  • Flexible and positive attitude

  • High level of integrity

  • Experience with CredentialStream/Verity preferred

  • Certified Provider Credentialing Specialist (CPCS) preferred

  • U.S. work authorization

  • Someone who embodies being 'Oaky'

What does being 'Oaky' look like?

  • Radiating positive energy

  • Assuming good intentions

  • Creating an unmatched patient experience

  • Driving clinical excellence

  • Taking ownership and delivering results

  • Being relentlessly determined 

Why Oak Street Health?

Oak Street Health is on a mission to 'Rebuild healthcare as it should be'', providing personalized primary care for older adults on Medicare, with the goal of keeping patients healthy and living life to the fullest. Our innovative care model is centered right in our patient's communities and focused on the quality of care over the volume of services. We're an organization on the move! With over 150 locations and an ambitious growth trajectory, Oak Street Health is attracting and cultivating team members who embody 'Oaky' values and passion for our mission.

Oak Street Health Benefits: 

  • Mission-focused career impacting change and measurably improving health outcomes for Medicare patients

  • Paid vacation, sick time, and investment/retirement 401K match options

  • Health insurance, vision, and dental benefits

  • Opportunities for leadership development and continuing education stipends

  • New centers and flexible work environments

  • Opportunities for high levels of responsibility and rapid advancement

 

Oak Street Health is an equal-opportunity employer. We embrace diversity and encourage all interested readers to apply. 

Learn more at www.oakstreethealth.com/diversity-equity-and-inclusion-at-oak-street-health