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Providence Supervisor, Provider Services in Santa Monica, California

Description:

Providence is calling a Supervisor, Provider Services (Full time/Day shift) to Providence Saint Johns Medical Foundation in Santa Monica, CA .

We are seeking a Supervisor, Provider Services who will fill a key position in providing supervision of credentialing and onboarding staff. Key to the position is accountability and responsibility for assuring that all professional staff and allied health practitioners are credentialed in accordance with professional staff bylaws, policies and procedures, The Joint Commission (TJC) standards as well as state and federal rules, if applicable.

The position will manage all processes related to timely and appropriate verifications of all aspects of credentialing and privileging of the professional staff, and serves as resource to credentialing staff. The demonstration of ability to use credentialing software, creation and analysis of reports is important to the role. The Supervisor will monitor productivity of the team and leads in managing quickly changing priorities for all assignments. In addition, the position will provide training to staff on department credentialing processes and develop training guides for Credentialing Department tasks.

MAJOR CHALLENGES:

  1. Collaborating with team members in coordinating and ensuring completion of time-sensitive information among competing priorities.

  2. Maintaining flexibility among large set of data and information that require attention to detail.

  3. Ensuring that security of credentialing information is maintained and is accurate, and kept confidential at all times.

Patient Population Served: Not Applicable

In this position you will have the following responsibilities:

  • Provide supervisory responsibilities to credentialing and onboarding caregivers

  • Promote positive department working conditions with ongoing evaluation of processes and offers suggestions for improvement. Offer and accept constructive feedback in positive and courteous manner

  • Communicate updates in credentialing data and status to appropriate departments, staff members, and physicians for corresponding contract changes

  • Format Provider Number Requests for the new providers to bill in the Providence Physician Services Practice Management Software (MD Staff), order provider numbers as needed, and update progress and changes needed to provider numbers, dependent on ongoing credentialing status

  • Process Accounts Payable functions (check requests, invoices, tracking, follow-up, distribution, communication) that are applicable to provider credentialing, privileging, or licensing

  • Maintain departmental grids and databases for credentialing, licensing, privileging and payer data within appropriate, assigned timelines. Audit grids for deficiencies and accuracy; update information as needed, disseminates information as needed and / or assigned

  • Maintenance of provider credentialing files: establish file; run appropriate queries and data bank searches; identify potential timeframe gaps or application deficiencies and request information to correct; maintain and audit file on an ongoing basis; copy and disseminate credentialing information and documents as needed; update file as needed and/or assigned

  • Partner with Medical Staff administration leaders to utilize audits and assure appropriate timely and completion of credentialing files

  • Responsible for the timely coordination of and collaborating with Mission, IT, Finance, Marketing, Revenue Cycle, Compliance, and Operational leaders to ensure providers are prepared to see patients

  • Ensure clinic business licenses and regulatory enrollments occur timely (Medicare, Medi-Cal, CLIA, City Business Licenses, malpractice insurance, etc.)

  • Support refocusing of workload/priorities when necessary in order to meet project deadlines

  • Independently coordinate, prioritize and complete numerous ongoing and special projects. Complete projects thoroughly, accurately, and timely, utilizing critical thinking skills

  • Leadership/Supervision:

  • Provide supervisory responsibilities to credentialing and onboarding caregivers

  • Promote positive department working conditions with ongoing evaluation of processes and offers suggestions for improvement. Offer and accept constructive feedback in positive and courteous manner

  • Development:

  • Keep abreast of department policies and procedures by positively participating in staff meeting and in-services

  • Assume responsibility and accountability for own professional growth. This includes maintaining licenses as relevant, and completing all required in-service programs

  • Budgetary:

  • Compliance with Providence Physician Services operating and capital budgets

Qualifications:

Required qualifications for this position include:

  • Bachelor's Degree

  • Certified Provider Credentialing Specialist (CPCS); OR must become certified within 3 years

  • Certified Professional Medical Staff Services Management (CPMSM) optional

  • 2 years leadership experience required with progressively responsible roles

  • 3 years experience in a medical credentialing environment (payer, IPA, medical group, or institutional privileging)

  • Experience with strong focus on customer service and producing positive outcomes

  • Demonstrates experience with and use of credentialing software program

  • Demonstrates experience in medical staff affairs, credentialing, and privileging

  • Knowledge of physician payer credentialing, physician and allied provider privileging, and physician/provider and site regulatory licensing required

  • Demonstrates a high level skill using standard Microsoft Office desktop applications (Word, EXCEL, PowerPoint, Outlooks)

  • Must demonstrate proficiency in online credentialing applications and enrollment platforms, such as PECOS, PAVE, MD Staff, CAQH, NPDB, GSA, OIG, AMA and AOA profile service

  • Must be self motivated and organized in task completion

  • Must be detail oriented

  • Excellent communication skills

  • Must be able to speak, read, and write professionally in the English language. Must type a minimum of 35 wpm

  • Must be tactful and proficient in conflict resolution

  • Must be able to work independently and with a team

  • Must be able to deal effectively with all levels of Providence personnel, the public and physicians

Preferred qualifications for this position include:

  • 4 years experience in medical staff/provider services, project management and administrative support

About the location you will serve:

Providence Health & Services is further developing its physician integration strategy. As part of this growth, Providence Saint John’s Medical Foundation came into flourishing. Saint John’s Medical Foundation is an integrated, not-for-profit network of medical clinics and affiliated services, servicing the greater Santa Monica and Los Angeles area. The Foundation is expected to continue to grow in the next several years, bringing with it facilities, staff and physician growth to support that objective.

For information on our comprehensive range of benefits, visit:

http://www.providenceiscalling.jobs/rewards-benefits/

Our Mission

As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.

About Us

Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Schedule: Full-time

Shift: Day

Job Category: Clinical Lead Supervisor/Manager

Location: California-Santa Monica

Req ID: 274108

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