Supervisor Credentialing

Boston, MA, United States

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives.

The CVO Supervisor of Credentialing Specialists provides leadership, accountability and direction to credentialing specialists for assigned hospitals.

Creates a culture of engaged colleagues through promotion of BILH guiding principles and the development, mentorship and creation of a positive service oriented work culture.

Handles, with discretion, issues that are significant, complex, multidisciplinary, sensitive, and confidential.

Exemplifies a culture of excellence and customer service in all processes with internal and external customers including current and future members of the medical staff and other LIPs as well as clinical and administrative leaders within BILH.

Possesses and/or develops a strong grasp of the medical staff operations and the cultures of each affiliated institution and works to find common ground. Works to develop an overall singular culture of excellence and efficiency system wide.

Job Description:

Essential Responsibilities:

Oversee and assist with application management and verification activities, preliminary analysis of application and verification information, and analyzing verification information, to include identifying red flag and/or adverse information and notifying CVO leadership in accordance with CVO policies.

Oversee the monitoring of expiring information such, as but not limited to, federal and state DEA, state professional license(s), professional liability insurance, and specialty board certification status.

Maintain and update credentials file(s) (paper and/or electronic as applicable), management of database entries for accuracy and completeness, and maintenance of electronic files as required.

Timely and accurately prepare credential files for audit and submission to assigned hospitals and appropriately and timely communicate with assigned medical staff offices.

Take a proactive role in monitoring and assisting in improving staff productivity in accordance with standard turn-a-round times, assist in new staff training (as assigned) and assist in the annual evaluation process.

Maintain a working knowledge of relevant regulatory standards (i.e., TJC and NCQA), state and federal requirements, and applicable Medical Staff Bylaws.

Assist with the development and implementation of credentialing and re-credentialing workflows to ensure efficient and effective alignment of processes and in the development or revision of credentialing related forms.

Participate in special project teams as assigned.

Enforce internal procedures and controls and problem resolution.

Continually strive to achieve individual, team, and departmental goals.

Has the authority to direct and support employees daily work activities. Has authority to undertake or recommend the following employment actions: hiring, termination, corrective action and performance reviews. Direct Reports: 4-6 Indirect Reports: None

Required Qualifications: High School diploma or GED required.

Certified Professional in Medical Staff Management (CPMSM) OR Certified Provider Credentialing Specialist (CPCS) preferred OR Achievement of certification (CPMSM/CPCS) within 24 months of becoming eligible.

3-5 years related work experience required in CVO or Medical Staff Services in an acute healthcare setting and 1-3 years supervisory/management experience required

Advanced skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web-based applications. May produce complex documents, perform analysis and maintain databases.

Preferred Qualifications: Knowledge of credentialing software and associated applications

Experience in credentialing and privileging

Competencies: Decision Making: Ability to make decisions that are guided by precedents, policies and objectives. Regularly makes decisions and recommendations on issues affecting a department or functional area.

Problem Solving: Ability to address problems that are highly varied, complex and often non-recurring, requiring staff input, innovative, creative, and Lean diagnostic techniques to resolve issues.

Independence of Action: Ability to set goals and priorities for functional area. May make recommendations for department policies, practices and programs. Manager or Director provides broad guidance and overall direction.

Written Communications: Ability to summarize and communicate in English moderately complex information in varied written formats to internal and external customers.

Oral Communications: Ability to comprehend and communicate complex verbal information in English to medical center staff, patients, families and external customers.

Knowledge: Ability to demonstrate in-depth knowledge of concepts, practices and policies with the ability to use them in complex varied situations.

Team Work: Ability to act as a team leader for small projects or work groups, creating a collaborative and respectful team environment and improving workflows. Results may impact the operations of one or more departments.

Customer Service: Ability to provide a high level of customer service and staff training to meet customer service standards and expectations for the assigned unit(s). Resolves service issues in the assigned unit(s) in a timely and respectful manner.

Physical Nature of the Job:

Sedentary work: Exerting up to 10 pounds of force occasionally in carrying, lifting, pushing, pulling objects. Sitting most of the time, with walking and standing required only occasionally

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) and COVID-19 as a condition of employment. Learn more about this requirement.

More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.

Equal Opportunity Employer/Veterans/Disabled