Credentialing Manager Jobs in Michigan (NOW HIRING)

Ensures thetimelycompletion of an application forinitialand/or recredentialing byassistingthe applicant insubmittingall documentation necessary to process the application. Performs a variety of credentialing tasksatthe direction ofCVO managementto complete the credentialing process forTrinity Health RHMs.

This position is an integral part of the credentialing team andis responsible forfollowing credentialing policies and procedures;maintainingan accuratephysician data base; collecting data; andparticipatingin development and implementation of changes to the credentialing processes.

ESSENTIAL FUNCTIONS

Knows, understands, incorporates, anddemonstratesthe Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions.

Assists the Manager in the identification and scheduling of reappointment candidates.

Performs file audits and provides feedback on completed initial andreappointmentcredentialing files.

Assistsin the training and orientation of new team members.

Assistsin daily data entry to ensurean accuratephysician data base.

Facilitates the integration of new RHMs into the CVO byassistingwith data entry and/or data conversion into thephysiciandata base.

Communicates regularly with applicants andthe RHMsto complete all requirements of thecredentialing criteria within specifiedtimeframes.

Contacts various primary sources to gather the required verifications to complete the background investigation via telephone, fax transmissions,mailingsand Internet to ensure rapid completion of the application.

Prepares documentation of all verifications including a summary of all verified references for each completed credentials file.

Assistsin the reappointment process; collecting required information, verifying information, and completingappropriate follow-upto complete the reappointment application.

Meets processing time thresholds consistently and with minimal error.

Assistswith theinitialdrafting of RHM privilege forms in the PCCB module of the credentialing data base.

Maintains the confidentiality of informationacquiredpertaining topatient, physicians, employees, and external entities.

Maintainsacustomer-focusattitude,goodrapport, and cooperative relationships.Approachesconflict in a constructive manner.Helpstoidentifyproblems, offer solutions, andparticipatein theirresolution.Tracks errors and complaints toassistwith process improvement activities.

Participates in professional development programs and professional organizations to grow in understanding of the various regulations and legislation of the health care industry as appropriate.

Maintains good rapport and cooperative relationships.Approachesconflict in a constructive manner.Helps toidentifyproblems, offer solutions, andparticipatein theirresolution.

Maintains the confidentiality of informationacquiredpertaining topatient, physicians, employees, and visitors toTrinity Health.Discusses patient and hospital information only amongappropriate personnelinappropriatelyprivate places.

Assumes responsibility forperformanceof job duties in the safest possible manner, toensurepersonal safety and that of coworkers, and to report all preventable hazards and unsafe practicesimmediatelyto management.

Performs other duties as needed and assigned by theDirector.

Maintains a working knowledge of applicable Federal,Stateand local laws/regulations; the Trinity Health Integrity and Compliance Program and Code of Conduct; as well as other policies and proceduresin order toensure adherence in a manner that reflects honest,ethicaland professional behavior.

MINIMUM QUALIFICATIONS

Mustpossesstwoyears of post-high school education, training, or experience.Associatesdegree inhealth administrationora relatedfield preferred.

One year of work experience in the health care environment and general knowledge of the health care industry including hospital settings, physician practices, and managed care organizations.

Knowledge and understanding of NCQA andTJC standards, NPDB guidelines, hospital policies and procedures, and general licensing regulations.

Knowledge and experience with database organization and management, report generating languages,PC'sandproficiencyin Windows-based word processing software.

Current CPCS and/or CPMSM eligibility by the National Association Medical Staff Services preferredbut notrequired.

Strong communicationskillsincludingthe ability to correspond effectively, as well as verbally convey information clearly, listen actively, and consider varying viewpoints when making decisions.

Strong statistical,analyticaland problem-solving skills.

Ability and desire to provide quality service to others.

Strong organizational skills and the ability to provide attention to detail and thoroughness.

Ability to work autonomously and within a team environment.

Mustpossessthe ability tocomply withTrinity Health policies and procedures.

PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS

Must be able to set and organizeownworkpriorities, andadapt to them as they change frequently.Must be able to work concurrently on a variety of tasks/projects in an environment that may be stressful with individuals having diverse personalities and work styles.

Ability to complete work during high-pressure periods whilemaintainingflexibility and a pleasant attitude.

Hourly Pay Range: $21.95 - $32.92