/ Department Supervisor, Credentialing
Supervisory Position Description
/ Department Supervisor, Credentialing
SupervisoryPosition Description
Job Title: / Department Supervisor, Credentialing / Job Code: / 22790001
Date Created: / September 2014
Reports To (Title): / Manager, Medical Staff Office / Date Revised:
Approved by: / Director, Provider Services / Update by:

Position Purpose

Supervises the onboarding process of all providers for North Memorial Medical Center, North Memorial Clinics, Maple Grove Hospital, North Memorial Ambulatory Surgery Center and other patient care facilities. The onboarding process encompasses both medical staff credentialing and privileging and payer enrollment. It also includes making arrangements for a wide-range of pre-appointment or pre-employment activities such as EMR training and coding training. The Supervisor oversees all activity of the onboarding team to ensure every provider has a excellent experience.

Functional Accountabilities

  • Develops, in conjunction with the Manager, an effective, efficient system for the credentialing, onboarding and payer enrollment functions.
  • Ensures applications are processed in accordance with established policies, rules and regulations, bylaws, accrediting bodies and regulatory governmental standards.
  • Responsible for all aspects of credentialing and re-credentialing with hospitals, health plans and other patient care facilities.
  • Ensures the onboarding process for employed and affiliate providers is an excellent experience.
  • Implements quality management systems for the initial and re-credentialing of all providers.
  • Establishes delegated credentialing agreements with health plans.
  • Manages workload and supervises credentialing specialists.
  • Works with North Memorial Health Care departments and other customers to identify credentialing needs and to address any concerns/questions.
  • Maintains awareness of credentialing trends and resources to streamline processes.

Leadership Accountabilities

  • Achieves key patient care, financial and/or operational outcomes as found in annual work plan.
  • Leverages and adheres to systems and processes that drive accountability for patient care, financial and operational outcomes.
  • Works effectively with team colleagues and other key partners to execute divisional and/or departmental initiatives and day-to-day operations.
  • Effectively communicates with teammates and key partners.
  • Develops talent within the team, including acquiring, engaging and retaining.
  • Staffs, organizes and schedules the team to leverage maximum labor productivity.
  • Understands, tracks and focuses the team on metrics that measure key business outcomes.
  • Choose the applicable statement for the job description.

(Operations Supv/Mgr) Translates organization vision and strategies to team level and mobilizes allocated resources to achieve profitable growth.

(Business Support Supv/Mgr): Translates business support vision and strategies to team level and mobilizes allocated resources to support business operations.

License/Certification Accountabilities

Competencies

Thought Leadership (Analysis, Strategic Thinking, Financial Acumen)

  • Analyze Issues and Solve Problems
  • Understand Strategies

Results Leadership (Focus on Customers, Managing Execution, Results Orientation)

  • Seek Customer Satisfaction
  • Execute Efficiently
  • Show Initiative

People Leadership (Engage and Inspire, Talent Enhancement)

  • Encourage Commitment
  • Select and Develop

Personal Leadership (Adaptability)

  • Readily Adapt

Compliance

  • Recognizes and complies with legal regulatory, accrediting and procedural requirements related to area of responsibility.
  • Understands and follows principles and standards as outlined in North Memorial's Corporate Code of Conduct.
  • Reports violations or areas of concern to supervisor or Corporate Compliance Committee via established methods of communication.
  • Protects patient/employee privacy and only accesses patient/employee-related information as needed to perform job duties.

Basic Qualifications

Education

  • Two year business or technical college degree in an office or health care related field

(4 years hospital credentialing experience including some supervision may substitute for degree).

  • Preferred Education - Bachelor's degree in Business or Health Care related field.

Experience

  • 3 years experience in a hospital credentialing department including 1 year of supervisory experience.
  • Preferred Experience - 5 years experience in a hospital credentiaing department, including 1 year of supervisory experience.

Knowledge, Skills and Abilities

  • Understanding of relationship and differences between hosptial and managed care credentialing
  • Ability to interpret and implement accreditation standards.
  • Working knowledge of legal issues related to credentialing and peer review
  • Understanding of computer technology related to credentialing
  • Experience working with senior management and physicians
  • Exceptional customer service, interpersonal, organizational, business communication and time management skills.
  • Ability to work with a wide range of sensitive and confidential issues.
  • Solid PC skills (Excel, Word)

Licensure/Certification(s)/Registration

None (Check here if no preferences or requirements exist. Otherwise, enter descriptions and requirement types below).

Certified Provider Credentialing Specialist certification. If not certified in this area, must become certified within one year of employment in this role. / NMHC StandardSelect Requirement TypeFederal RequirementState RequirementCommunity StandardNMHC Preferred
Enter Description / Select Requirement TypeFederal RequirementState RequirementCommunity StandardNMHC StandardNMHC Preferred
Enter Description / Select Requirement TypeFederal RequirementState RequirementCommunity StandardNMHC StandardNMHC Preferred
Enter Description / Select Requirement TypeFederal RequirementState RequirementCommunity StandardNMHC StandardNMHC Preferred
Enter Description / Select Requirement TypeFederal RequirementState RequirementCommunity StandardNMHC StandardNMHC Preferred

Physical Demands

Walking/Standing......

Sitting......

Standing in one place......

Reaching

Above Shoulder......

Away from Body......

Climbing......

Height ( laddersstairs)

Pulling/Pushing......

Crawling, Kneeling, Squatting......

Bending/Stooping......

Balancing......

Twisting/Turning......

Repetitive Movement (hands/wrists)...

Check box below if job requires repetitive hand action.

Right / Left (Hand)

Simple Grasping

Firm Grasping

Fine Manipulating

Keyboarding

Repetitive Foot Movement......

Lifting/Carrying / WEIGHT / DISTANCE / FREQUENCY
Above Shoulder / Select One<10#11-24#25-50#>50# / Select One<5'6-10'11-20'>20' / Select OneNeverSeldom, 1-5% or less than 1 hour of an 8 hour workOccasional, 6-33% or 1 - 2 1/2 hours of 8 hour worFrequently, 34-66% or 2 1/2 to 6 hours of an 8 houContinuous, 67-100% or 6 to 8 hours of an 8 hour w
Waist to Shoulder / Select One<10#11-24#25-50#>50# / Select One<5'6-10'11-20'>20' / Select OneNeverSeldom, 1-5% or less than 1 hour of an 8 hour workOccasional, 6-33% or 1 - 2 1/2 hours of 8 hour worFrequently, 34-66% or 2 1/2 to 6 hours of an 8 houContinuous, 67-100% or 6 to 8 hours of an 8 hour w
Knee to Waist / Select One<10#11-24#25-50#>50# / Select One<5'6-10'11-20'>20' / Select OneNeverSeldom, 1-5% or less than 1 hour of an 8 hour workOccasional, 6-33% or 1 - 2 1/2 hours of 8 hour worFrequently, 34-66% or 2 1/2 to 6 hours of an 8 houContinuous, 67-100% or 6 to 8 hours of an 8 hour w
Floor to Knee / Select One<10#11-24#25-50#>50# / Select One<5'6-10'11-20'>20' / Select OneNeverSeldom, 1-5% or less than 1 hour of an 8 hour workOccasional, 6-33% or 1 - 2 1/2 hours of 8 hour worFrequently, 34-66% or 2 1/2 to 6 hours of an 8 houContinuous, 67-100% or 6 to 8 hours of an 8 hour w
Carrying / Select One<10#11-24#25-50#>50# / Select One<5'6-10'11-20'>20' / Select OneNeverSeldom, 1-5% or less than 1 hour of an 8 hour workOccasional, 6-33% or 1 - 2 1/2 hours of 8 hour worFrequently, 34-66% or 2 1/2 to 6 hours of an 8 houContinuous, 67-100% or 6 to 8 hours of an 8 hour w

Physical Senses (mark if required)

Vision

Color Vision

Hearing

Talking

Smelling

Feeling

Physical Exposure/Environment (mark where applicable)

Hazardous Substances

Gases

Chemical

Fumes

Dust

Infectious Diseases

Harmful Physical Agents

Heat/cold/frequent temp. changes

Wet/dry

Noise

Humidity

Ionizing/Non-ionizing radiation

Vibrations

Unprotected heights

Electrical Hazards

Mechanical Hazards (i.e., equipment, machinery, moving parts, etc.)

Lighting: Bright, Dim

Time Spent Inside (Specify Hours)8

Time Spent Outside (Specify Hours)0

Time Spent in Vehicle (Specify Hours)0

Cognitive/Mental Demands

Time Awareness......

Initiation of Work......

Receptiveness to Change....

Required Sequences in Work..

Attentiveness Duration......

Attentive Intensity......

Co-Worker Support......

Mathematical Aptitude......

Reading......

Writing......

Memory......

Reasoning......

Problem Solving......

Tact......

Social Interactions......

Appearance Demands......

Conflict Management......

Detail Oriented......

Flexible......

Working Conditions

  • Generally day hours with flexibility to meet the demands of the position.

Printed: January 18, 2019
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