US Anesthesia Partners is seeking a Regional Credentialing Manager to join our team in Dallas, TX. This is a hybrid role with an expectation of onsite presence twice a week.
This position oversees the credentialing operations of the USAP Dallas platform to develop, manage and monitor processes and procedures that support the credentialing & re-credentialing processes. Oversight of all credentialing functions including application management and primary source verification. Ensures compliance with the appropriate accrediting and regulatory agencies.
Job Highlights
ESSENTIAL DUTIES AND RESPONSIBILITIES (include but not limited to):
At a regional level, supervises direct and indirect staff members with performance and talent management. Leads credentialing team with coaching and feedback of employee work performance, work behaviors to develop skills and monitor team workflows.
Collaborate with operations team to create credentialing standards and procedures and execute the implementation and monitoring of standards and procedures within assigned region.
Monitor credentialing departments for possible clinical and financial risks as it pertains to provider credentialing and onboarding.
Administers teams to be accountable for quality and production standards and monitors progress with established goals and metrics.
Oversees the onboarding of new groups and facilities.
Works with leadership teams to ensure compliance with (NCQA and CMS standards and guidelines; identifies and monitors The Joint Commission, URAC, AAAHC accreditation standards, and policies, and other federal and state legislation, as appropriate)
Partners with organizational key stakeholders to support and prepare for regulatory, NCQA, CMS, and client health plan audits.
Establish and foster strong working relationships with billing departments to improve processes and communication between the enrollment and billing departments.
Maintain department budgets at or below the yearly projections.
Models collegial environment, which fosters teamwork for local teams, with other members of the clinical services, operations and field providers.
Provides regular reports and updates to RCM and national leadership, as applicable.
Work with local leadership to plan and prepare for future growth and needs of local offices.
EDUCATION/TRAINING/EXPERIENCE:
B.S. degree (equivalent or higher) in business administration or health care related field preferred.
CPMSC/CPCS Certification preferred.
5-7 years of management experience in the healthcare industry required, particularly in Anesthesia.
Knowledge of hospital credentialing
Knowledge of Windows, Power Point, Word and Excel or similar programs required.
US Anesthesia Partners, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, gender identity, sexual orientation, pregnancy, status as a parent, national origin, age, disability (physical or mental), family medical history or genetic information, political affiliation, military service, or other non-merit based factors.
JOB REQUIREMENTS (Knowledge, Skills and Abilities):
Strong working knowledge and of hospital credentialing and provider enrollment with commercial and government payers.
Direct supervisory experience overseeing management talent.
Ability to communicate clear expectations and company vision and values to managers.
Must be able to select, develop, effectively manage and motivate managers.
Database management skills, including querying, reporting and document generation.
Poses and demonstrate analytical skills to make administrative and procedural decisions and use independent judgement.
Communicate effectively, both written and verbal.
Demonstrate ability to work cooperatively with employees, peers, senior leadership, physicians, and external customers.
Ability to prioritize and organize work and projects to ensure focus on high impact/value added activities and meet deadlines.
Ability to effectively work well under pressure in a fast paced environment.
Ability to recognize and effectively respond to urgent situations.
Act decisively, making good ethical decisions based on analysis, experience and judgement in a timely manner.
Working knowledge of computers and general patient accounting and credentialing systems.
Must possess a professional pleasant disposition and tolerance for diverse personalities.
Must demonstrate flexibility and ability to adapt to process changes as necessary to meet the needs and goals of the company.
Support department and organizational goals that contribute to the success of the organization.
Display self-accountability and embrace personal professional growth and development.
Internal Number: 2023-12195
About US Anesthesia Partners
USAP is the highest quality, single-specialty, anesthesia practice in the country. We’re owned and clinically governed by practicing physicians, including some of the world’s foremost experts in anesthesia. Our anesthesiologists, CRNAs, CAAs, and all members of our care teams share operational and clinical best practices organization-wide, helping to facilitate the delivery of consistent, high-quality services for patients, surgeons, facilities, and payers.
At USAP, clinical excellence is supported by a world-class business leadership team. Our capital partners are Welsh, Carson, Anderson & Stowe; Berkshire Partners; and GIC. All three are investment firms with significant experience investing in and building leading healthcare companies.
