The System Credentialing Manager is responsible for the daily business operations of the System Credentialing Office services to all Fairview hospitals, clinics, networks, and applicable surgery centers. The Manager oversees the operational performance of all credentialing and privileging functions across the system, and for delegated payer plans. This position must maintain an awareness of credentialing issues, trends, and resources to assure efficient processing of applications that meets all regulatory standards and legal compliance.

• Effectively manages Credentialing staff to achieve high performance in all the different credentialing and privileging processes, quality reviews, ongoing maintenance of practitioners license, DEA, malpractice insurance and Board Certification.
• Oversees and assures timely and high-quality processing of Initial, Update, Reappointment, Additional Privilege applications, and Expirable maintenance to meet Joint Commission and NCQA standards always.
• Serves as a Credentialing Resource to all medical staff offices, onboarding and recruiting departments, independent clinic groups, service line leaders, provider enrollment department.
• Ensures overall compliance with federal, state, and local regulations and other requirements (The Joint Commission, CMS, NCQA) for all credentialed practitioners.
• Adheres to confidentiality needs and manages the release of sensitive credentialing information and verifications for the entire system.
• Manages workflows and resources in the department to maximize efficiency and effectiveness from a system perspective.
• Develops, implements, and communicates departmental and system policies and/or processes in partnership with the System Director of Credentialing and Privileging.
• Maintains appropriate, effective communication with all practitioner applicants and departmental leaders on credentialing and privileging requirements.
• Manages workload and supervises direct reports: Conducts annual performance reviews with direct reports, provides direct reports ongoing feedback and coaching throughout the year, conducts crucial conversations, initiates formal Corrective Action process, as appropriate
• Staff Development: Participates in the interviewing/hiring process, coordinates and directs new employee orientation, facilitates goal development and ongoing review of achieving goals
• Proactively works with Fairview departments and external customers to identify credentialing needs for Fairview business.
• Builds a culture that engages employees, conducts employee rounding, recognizes employees for their contributions
• Assists with other projects and duties as assigned by department director.

Education

• Two-year business or technical college degree in an Office or Healthcare related field, or
• Credentialing experience of 6 years in a hospital credentialing leadership position

Experience

• 2 years experience in a hospital or health plan credentialing department in a leadership role

License/Certification/Registration

• Certified Provider Credentialing Specialist (CPCS) certification or Certified Professional Medical Services Management (CPMSM) through the National Association of Medical Staff Services, either must be achieved within one year of employment start date.