PHMC is proud to be a leader in public health. PHMC requires all employees to be fully vaccinated for COVID-19 before the first day of employment. We will offer the vaccination at no cost via our Health Centers.

Job Overview: Lead and develop the team to manage, coordinate, and execute credentialing and re-credentialing as well as assist with contracting. Supervise the Credentialing Coordinator. Drive continual process improvement.

Responsibilities:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below must be representative of the knowledge, skills, minimum education, training, licensure, experience, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Lead and develop the team to manage, coordinate, and execute credentialing and re-credentialing as well as assist with contracting.
• Supervise the Credentialing Coordinator, who performs a variety of tasks for Non-Licensed Independent Practitioners.
• Conduct primary source verification for all credentialing and re-credentialing applications.
• Monitor the progress and completion of all payer site visits by the provider network team to ensure completion within the established timeframe.
• Gather all critical data elements from the providers and other entities and ensure that the credentialing company enters information accurately.
• Oversee and report areas of deficiency, sanctions, and infractions related to licensure and practice.
• Drive continual process improvement for tools and processes to meet credentialing needs.
• Address all credentialing issues for incoming and existing providers in a timely manner.
• Initiate, update, and maintain Clinical Laboratory Improvement Amendments (CLIAs) for each health center and shelter.
• Initiate, update, and maintain Peer Reviews twice a year for all Licensed Independent Practitioner Providers.
• Obtain Promise logins for each site, Penn Physician Links for individual staff, and Temple Healthcare Links for individual staff.
• Verify provider employment on the HRSA Bureau of Healthcare Workforce portal.
• Collaborate with all levels of management across cross-functional departments to achieve departmental goals and objectives.

Skills:

• Program planning and implementation skills
• Research skills
• Comfortability in making procedural decisions
• Strong oral and written communication skills
• Database management skills
• Intermediate knowledge of PC applications, including Microsoft Office
• Strong organizational skills
• Ability to perform in a results-oriented environment

Position Requirements:

• Five or more years of credentialing experience required
• High school diploma required
• College degree preferred

Salary Grade: 19

EOE