General Hours of Work: Monday - Friday (Days, 8a-5p CST, some evenings/weekends)

Exempt/Nonexempt: Exempt (salaried)

Department/Unit: Quality & Compliance 

Reports To: Executive Director - Quality/Compliance/Medical Support 

SUMMARY:

Responsible for administering licensing, credentialing, and privileging services. Manages a team of Licensing and Credentialing Specialist who are responsible for primary source credentials verification, and the licensing, credentialing, and privileging of eCare clinical providers, including advanced practice and allied health providers. Ensure team is delivering a consistent, high-quality support to internal and external customers, continually developing and executing strategies to meet company needs. Responsible for management of the Credentialing Committee, including development of monthly agendas, content of the meeting and minutes. Facilitates accreditation survey preparations regarding credentialing, licensing, and privileging processes. Responsible for credentialing analysis, quality assurance, planning, customer/vendor relationships, and continuous improvement of operational performance. The functions of this position require developing and supervising excellent communications and rapport with the provider(s) and credentialing networks both within and outside Avel eCare and may involve working under unusual pressure with deadlines or requests

ESSENTIAL FUNCTIONS:

• Manage the output of a team of employees engaged in licensing, credentialing, and privileging of providers and clinicians. Analyze and implement process improvements to enhance efficiency of licensing, credentialing, and privileging.
• Responsible for the development and oversees internal team operations including team processes and tool requirements to enable team members to meet company standards. Coordinates implementation all approved programs, projects, and major activities of the Medical Staff Office.
• Manages the Credentials Committee agenda by providing completed files and completing preliminary review of the credentialing documents for privileging applications in accordance with policies, Joint Commission standards and State and Federal laws.
• Coordinate the workflow of gathering data for licensing and credentialing processes and troubleshoot escalated issues as appropriate. Utilizes effective communication with department staff and keeps Executive Director informed of workflow and staffing issues.
• Encourages and manages licensing/privileging staff’s development through measurement tools and performance improvement.
• Ensures that organizations partnering with Avel eCare for credentialing data receive timely and accurate materials to review and that these materials follow regulatory and accreditation standards.
• Manages confidential files and electronic database of all eCare Clinical Providers reflecting their status.
• Coordinates and maintains Medical Staff Office “governance documents” such as rules and regulations, related documents (organization and function manual, credentials policy, etc.), and policies and procedures of the Medical Staff Office.
• Provides appropriate documentation of all activities within the scope of the position, allowing for follow through on committee actions or change in policies, and confidential Clinical Provider committee actions.
• Has knowledge and facilitates compliance of The Joint Commission standards, National Committee on Quality Assurance and State and Federal regulations related to Provider licensing, credentialing, and privileging.
• Works with the Quality Department and responsible for the provider evaluation process, including providing customers and internal stakeholders with necessary quality reports for provider reappointment.

ESSENTIAL QUALIFICATIONS:

Hours are variable and may involve working after 5pm and work occasionally may be performed under unusual pressure with deadlines or requests. To perform this job successfully, an individual must be able to perform each essential function satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required to perform these essential functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions, so long as the accommodations do not cause undue hardship to the employer.

REQUIRED EDUCATION and/or EXPERIENCE:

• Bachelor's degree or equivalent from four-year College or technical school; or 4 - 8 years related experience and/or training; or equivalent combination of education and experience.

REQUIRED Licenses/Certificates:

• Obtain Certified Professional Medical Services Management and/or Certified Provider Credentialing Specialist by the National Association of Medical Staff Services when eligible.
• Affiliation with the National Association Medical Staff Services and the State Association Staff Services is strongly encouraged.

About Avel eCare

Avel eCare is a nationally recognized telemedicine care provider offering the largest and most comprehensive virtual health networks in the world. Based in Sioux Falls, South Dakota, Avel operates a multispecialty telemedicine network, partnering with more than 650 health care systems, rural hospitals, outpatient clinics, long-term care facilities, school districts, prisons, skilled nursing facilities and law enforcement agencies to deliver innovative telemedicine care across the country.

During the past three decades, Avel has developed eight distinct telehealth services, —Behavioral Health, Critical Care, Emergency, Hospitalist, Pharmacy, Specialty Care, Senior Care and School Health—in response to needs expressed by the communities and clinicians whom Avel serves. Within the past year alone, Avel’s virtual health care delivery model has impacted the lives of nearly two million patients. The efficiency of these telehealth services have saved health care costs and unnecessary time and travel for patients and physicians. On a national and world level, we are a model of how telehealth presents effective solutions today and tomorrow’s most daunting challenges. 

An innovative spirit among Avel eCare employees provided the spark that started Avel eCare’s telemedicine movement and is what continues to fuel our ability to transform the way healthcare is delivered across the world today. When you join the Avel team, you’ll appreciate the dedication, collaboration and support of other highly skilled professionals who work with you onsite in our virtual hospital hub or through our remote workforce.

Mission

Every person and every community deserves access to high quality care. Avel’s experts collaborate with local clinicians through telemedicine, to deliver high quality care when and where it’s needed.

Vision

Avel eCare serves as a catalyst for change. We are creating a future of health care without boundaries through Service, Quality, Collaboration, and Innovation.