Credentialing Manager

Position Summary:  

The Credentialing Manager is responsible for aspects of the credentialing, re-credentialing and privileging processes for all medical and dental providers who provide care at Tampa Family Health Centers, Inc. (TFHC).     Responsible for ensuring providers are credentialed, appointed, and privileged with health plans and hospitals (if applicable); responsible for oversite of all activities and staff in the Credentialing Department

Essential Functions:  

• Maintain up-to-date data for each provider in credentialing databases and online systems; ensure timely renewal of licenses and certifications
• Track provider applications through the credentialing and enrollment process with the client health plans to ensure timely processing through completion; ensure that all credentialing files are completed timely for Board review/approval
• Assist in the creation, review and maintenance of credentialing policies and procedures, advising on the development of critical corporate guidelines and best practices
• Maintain utmost confidentiality of all information, strictly adhering to all state, federal, HIPAA and TFHC policies and procedures
• Ensure open lines of communication within credentialing department  
• Timely communication with providers regarding credentialing issues
• Complete Group/Facility applications
• Responsible for issue resolution between THFC and medical plans 
• Provides reports to the client health plans in accordance with contractual provisions; prepares reports for the Credentialing Committee, Quality Improvement and Compliance Committee
• Provide direct supervision and oversight to the credentialing staff, to include:
• Work assignments and scheduling; PTO management and approval of time; keep accurate payroll records
• Orientation and training of new hires; ongoing training
• Responsible for all direct employee personnel issues and processes, including performance management and appraisal processes

Other duties as assigned

General Duties: 

• Support the Mission, Vision and Values of TFHC
• Foster and support a teamwork environment
• Accurate and timely completion of other duties, as assigned

Knowledge and Experience: 

• Minimum (2) years experience in a healthcare administrative office setting
• Minimum (1) year of supervisory experience

 Education, Certification Training and License:

• High school diploma, or equivalent
• Bachelor’s Degree preferred