Director of Credentialing
Discover Better Health Careers with Rendr!
Who We Are
Rendr is the leading primary care focused, multi-specialty medical group dedicated to serving the Asian community in New York City. We strive to provide world-class, value-based health care with kindness at more than 100 clinical offices throughout Brooklyn, Manhattan, Queens, Staten Island, and Nassau County.
Why Join Rendr?
- Opportunities for professional growth and development.
- Competitive salary and benefits package. (Salary is based on previous experience and years of service.)
- Join a team that values employee, embraces diversity, and is committed to making a meaningful impact within our communities.
Benefits We Offer:
- Medical, Dental, and Vision Insurance
- 401k with Company Match
- Paid Time Off
- Paid Holidays/ Floating Holiday(s)
- Commuter Benefits
- Health Savings Account/ Flexible Spending Account/ Dependent Care Account
- Annual Performance Bonus
Job Position: Director of Credentialing
Reports to: Chief Medical Officer
The Director of Credentialing is responsible for administering credentialing and provider enrollment services throughout our practice network. In this role, the Director provides leadership to a team of credentialing specialists, manages and monitors processes and procedure for both the Rendr practice network and ECAP IPA network that support credentialing, re-credentialing, data management and delegated contracting to ensure compliance with all relevant standards, state and federal regulations, and health plan compliance.
Essential Functions
- Oversees the end-to-end credentialing process for healthcare providers, including physicians, advanced practice providers, and allied health professionals.
- Leads the credentialing team, cultivating a work environment that encourages teamwork, professional growth, and adherence to annual performance goals and metrics, and OKRs/KPIs.
- Develops, implements, and continuously improves credentialing, recredentialing, and privileging processes, policies, and procedures to ensure compliance with regulatory requirements.
- Audits and assesses the effectiveness and efficiency of both delegated and non-delegated credentialing end-to-end processes.
- Conducts thorough investigations and verifications of healthcare providers' credentials by directly contacting primary sources.
- Collaborates on and coordinates and supports credentialing committee activities, including scheduling, preparation, facilitation, and documentation of meetings.
- Analyzes provider educational and professional documents to ensure completeness and authenticity, meeting the organization's standards and oversees and maintains all provider credentials.
- Oversees the management of medical staff services, collaborating with leaders to ensure the delivery of high caliber, client-oriented services.
- Ensures compliance with and stays abreast of changes to legal and regulatory standards, including NCQA and National Practitioner Data Bank guidelines.
- Collaborates with relevant stakeholders on mutual topics of interest; provides updates on changes to relevant law, regulations, and industry standards.
- Leverages technology platforms and software systems to streamline credentialing processes, maintain records, and enhance efficiency.
- Creates and delivers training sessions for medical staff members on credentialing, privileging, and regulatory compliance.
- Facilitates and participates in payor meetings.
- Collaborates with RCM on credentialing and enrollment related claims projects and denials.
- All responsibilities listed above apply to both our Rendr practice network and our ECAP IPA network.
Qualifications
- Bachelor's Degree, preferable in a related area of study
- 6+ years progressive experience in provider credentialing and in privileging processes
- 5+ years leading and developing high performing teams
- Detailed understanding of Medicaid / Medicare / NYS and Managed Care Plan regulations
- Demonstrated knowledge of credentialing principles, industry regulations, state and deferral law, and accreditation standards
- Ability to multi-task and align priorities accordingly
- Demonstrated relationship building skills
- Clear and impactful written and verbal communication skills
- Goal driven with a firm understanding of credentialing department OKRs/KPIs
- Proficient in Microsoft Office
- Experience with credentialing platforms and related software
Rendr is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
We look forward to reviewing your application and exploring the possibility of you joining our team!