Tivity Health, Inc.

  • Credentialing Manager

    Job Locations US-AZ-Chandler
    Job ID
    2018-1520
  • Description/Responsibilities

    The Credentialing Manager is responsible for managing all aspects of the credentialing functions for Tivity Health including ensuring the timely and appropriate coordination, monitoring, and completion of the initial credentialing and re-credentialing verification processes for all contracted practitioners.

     

    S/he oversees the processes associated with provider applications and re-applications including data integrity and practitioner communications.

    1. Lead and direct the credentialing functions, including assessment of current processes to ensure that practitioner information and applications are properly verified and documented.
    2. Oversee primary source verification activities.
    3. Prepare for and coordinate Credentialing Committee meetings.
    4. Recommend process and system improvements to facilitate best practice operations in the credentialing function.
    5. Manage the credentialing team.
    6. Monitor the quantity and quality of the workload to ensure compliance with productivity and quality measures. Identify barriers to meeting goals and implement activities to alleviate barriers.
    7. Communicate with practitioners, senior leaders, colleagues, and other appropriate internal and external customers on credentialing related issues.
    8. Collaborate with all levels of management across cross-functional departments to achieve departmental goals and objectives.
    9. Provide reports (weekly/monthly) on critical aspects of credentialing process, including but not limited to, number of practitioner applications received, practitioners credentialed, and any outstanding issues.
    10. Other projects, as assigned.

     

    Qualifications

    • Bachelor’s degree in business administration or a health care-related discipline is preferred.
    • Minimum of 3+ years’ healthcare credentialing experience required.
    • Knowledge of NCQA credentialing standards
    • Proficiency using MicroSoft Office (including Word, Excel and PowerPoint)
    • Demonstrated leadership/supervisory experience
    • Familiarity with operational, financial, quality assurance, and healthcare regulations
    • Proven ability to execute plans and programs based on strategic initiatives
    • Demonstrated change management and project management skills
    • Knowledge of laws and regulations affecting credentialing
    • Demonstrated management and organizational skills
    • Excellent interpersonal and communication skills

     

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