Medical Staff Credentialing Director jobs in Maryland

Medical Staff Credentialing Director is responsible for all aspects of the verification process for medical staff incumbents. Develops and implements policies and protocols related to physician, nurse and other employee verifications and ensures that the organization and staff are in accordance with organizational and industry standards. Being a Medical Staff Credentialing Director requires a bachelor's degree in area of specialty. Typically reports to a top management. The Medical Staff Credentialing Director typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. To be a Medical Staff Credentialing Director typically requires 3+ years of managerial experience. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. (Copyright 2024 Salary.com)

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Director of Credentialing & Enrollment
  • Anne Arundel Dermatology
  • Linthicum Heights, MD FULL_TIME
  • Overview

    The Director of Credentialing & Enrollment will have oversight of the Clinician Credentialing Team. Responsibilities include leading, coordinating, implementing, monitoring and maintaining the clinician credentialing and provider enrollment process. The Director will facilitate all aspects of the clinician credentialing and provider enrollment process. Create standard operating procedures and process improvement initiatives. Clinician Credentialing and Provider Enrollment processes include development of relationships with internal clients, clinicians, and those external clients (third party payers including commercial insurance, managed Medicaid, Government, VA, and other carriers as needed) in an effort to support and further the company in its goals for growth. The Director of Credentialing & Enrollment is also responsible for the integrity and accuracy of information in credentialing software and other system related applications.

    Responsibilities

     

    • Manage the development and implementation of new Clinician credentialing.
    • Manage the development and implementation of clinician internal credentialing process.
    • Maintain credentialing software to ensure data accuracy and integrity of information.
    • Track and monitor new credentialing processes maintaining compliance with regulatory, state, federal and accrediting entities.
    • Lead credentialing discussions with third party payers, including established processes and new process implementation in accordance with established guidelines.
    • Establish and maintain positive working relationship with internal and external clients and clinicians.
    • Research various state enrollment policies/procedures to ensure thorough understanding of state requirements.
    • Facilitate creation and maintenance of Standard Operating Procedures; department Policies and Procedures; training and resource department materials.
    • Audit and review Credentialing Team results and reports including data integrity, accuracy, productivity to discover process improvement opportunities
    • Assist with Clinic/Group Medicare enrollment as needed.
    • Assist in development of KPIs and metric reports
    • Monthly department meetings and coordinator one-on-one (1:1) meetings are scheduled
    • Encourage continued educational and professional development of the Credentialing Team
    • Working knowledge of payer contracting
    • Assists with interviewing and hiring of Credentialing Team
    • Travel as needed
    • Other duties as assigned

    Qualifications

     

    • 7 years of related credentialing or provider enrollment experience required.
    • 7 years healthcare experience required.
    • Demonstrated knowledge of credentialing and enrollment
    • Ability to effectively manage priorities, drive results, and take initiative.
    • Strong communication and organization skills
    • Demonstrated organizational and project management skills to manage complex projects through effective planning, tracking, and resource allocation to meet business objectives and timeline
    • Ability to generate creative solutions, identify the best course of action and rapidly resolve complex issues/problems
    • Must be proficient in Microsoft Word, Excel, and PowerPoint.
    • NCQA certification experience
    • Delegated payer credentialing experience
    • Minimum of 3 years supervising experience
    • Multi state credentialing experience

    Licensure/Certifications/Education

    • BA/BS degree required, Professional Certification in area of Credentialing and Provider Enrollment preferred
  • 14 Days Ago

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Credentialing Coordinator - Medical Biller
  • Quadrant, Inc.
  • Annapolis, MD FULL_TIME
  • Credentialing Coordinator - Medical Biller Annapolis, Maryland MUST: Experienced Credentialing Coordinator - Medical Biller 2 years of Medical Biller experience Must have experience credentialing in m...
  • 6 Days Ago

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Director of Clinical Pharmacy
  • The Staff Pad
  • Baltimore, MD FULL_TIME
  • Are you looking for an exciting new opportunity that makes a difference? Apply today! The Director of Clinical Pharmacy Services is responsible for the leadership, direction, and coordination of clini...
  • 17 Days Ago

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Certified medical assistant
  • The Staff Pad
  • Columbia, MD FULL_TIME
  • The Staff Pad is looking for Certified Medical Assistants to work for a u00A0growing healthcare organization in Columbia, MD. Are you looking for an exciting, fast-paced position within the Healthcare...
  • 19 Days Ago

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Certified medical assistant
  • The Staff Pad
  • Randallstown, MD FULL_TIME
  • Certified Medical Assistant - Back Office Columbia, MD Compensation & Schedule : Full-time, 8 hour days Clinic Hours : 8a - 8p Most days will be 8a - 5p but must be able to work the occasional 11 : 30...
  • 1 Month Ago

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Certified medical assistant
  • The Staff Pad
  • Glen Burnie, MD FULL_TIME
  • Certified Medical Assistant - Back Office Glen Burnie, MD Compensation & Schedule : Full-time, 8 hour days Clinic Hours : 8a - 8p Most days will be 8a - 5p but must be able to work the occasional 11 :...
  • 2 Months Ago

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Associate Medical Director/Medical Director
  • Meet
  • Are you an experienced medical writer looking to step into a leadership role within a dynamic and innovative medical com...
  • 3/28/2024 12:00:00 AM

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Medical Director
  • Community Clinic Inc.
  • Silver Spring, MD
  • CCI Health Services mission is to deliver high quality, accessible care to our community members, leading the way to a m...
  • 3/28/2024 12:00:00 AM

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Medical Director
  • Premise Health Systems
  • Utica, IL
  • Premise Health is seeking a full time Medical Director to provide primary care and clinical leadership at their direct p...
  • 3/28/2024 12:00:00 AM

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Medical Director
  • Wexford Health Sources Inc
  • Kewanee, IL
  • To Apply for this Job Click Here Wexford Health Sources, one of the nation's leading innovative correctional health care...
  • 3/28/2024 12:00:00 AM

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Medical Director
  • Wexford Health Sources Inc
  • Sutton, WV
  • To Apply for this Job Click Here Wexford Health Sources, one of the nation's leading innovative correctional health care...
  • 3/28/2024 12:00:00 AM

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Medical Director
  • American Red Cross
  • Norfolk, VA
  • Please use Google Chrome or Mozilla Firefox when accessing Candidate Home. By joining the American Red Cross you will to...
  • 3/28/2024 12:00:00 AM

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Associate Medical Director or Medical Director
  • Cambia Health Solutions, Inc
  • Renton, WA
  • Associate Medical Director or Medical Director (dependent on experience) Remote must reside in ID, OR, WA, UT In this ro...
  • 3/27/2024 12:00:00 AM

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Medical Director/Senior Medical Director
  • GQR
  • The Director/Senior Medical Director, reporting to the Chief Medical Officer, plays a pivotal role in steering clinical ...
  • 3/25/2024 12:00:00 AM

Maryland (US: /ˈmɛrələnd/ (listen) MERR-əl-ənd) is a state in the Mid-Atlantic region of the United States, bordering Virginia, West Virginia, and the District of Columbia to its south and west; Pennsylvania to its north; and Delaware to its east. The state's largest city is Baltimore, and its capital is Annapolis. Among its occasional nicknames are Old Line State, the Free State, and the Chesapeake Bay State. It is named after the English queen Henrietta Maria, known in England as Queen Mary. Sixteen of Maryland's twenty-three counties border the tidal waters of the Chesapeake Bay estuary and...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Staff Credentialing Director jobs
$155,387 to $195,806

Medical Staff Credentialing Director in Hialeah, FL
The Medical Staff Services Facility Specialist is also responsible for the accuracy and integrity of the credentialing and clinical privileging database system.
January 09, 2020
Medical Staff Credentialing Director in Worcester, MA
Consult applicable state laws when determining how to maintain or store credentialing files and other peer review documents.
January 27, 2020
Medical Staff Credentialing Director in Abilene, TX
The Director of Medical Staff Credentialing will oversee, supervise, and direct the day to day operations of the medical staff credentialing and hospital privileges department.
November 30, 2019