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Director of Nurse Credentialin...

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Job Summary

Company
Location
Phoenix, AZ 85016
Industries
Healthcare Services
Job Type
Full Time
Employee
Years of Experience
5+ to 7 Years
Education Level
Bachelor's Degree
Career Level
Manager (Manager/Supervisor of Staff)

Director of Nurse Credentialing/Compliance

About the Job


Job Purpose:

To develop, implement, and monitor the credentialing and compliance process and standards of the external nursing staff of a Medicare certified home health agency by; offering information and opinion as a member of senior management; creating, monitoring, and implementing clinical and operational credentialing standards, processes/procedures. Oversee, manage, and audit the credentialing and compliance process of multiple medical disciplines in our offices throughout several western states.

Required Areas of Expertise:

·       Federal regulations (Medicare)

·       State regulations (Medicaid)

·       Non-governmental regulatory agencies (JCAHO & CHAPS)

·       Contractual & Insurance Compliance

·       Clinical Audit Preparation and Response

·       Qualitative and Quantitative Clinical Credentialing Measures ( Test/skills checklists )

·       Protocol for each clinical space we work in; home health, facility staffing, etc.

·       Employee background checks

·       Human Resource Policies/Procedures


Duties:

·       Accomplishes clinical credentialing and compliance strategies by determining accountability; communicating and enforcing values, policies, and procedures; implementing recruitment, selection, orientation, training, coaching, counseling, disciplinary, and communication programs; planning, monitoring, appraising, and reviewing job contributions; planning and reviewing compensation strategies

·       Develops credentialing and compliance organizational strategies by contributing information, analysis, and recommendations to strategic thinking and direction; establishing functional objectives in line with organizational objectives

·       Establishes credentialing and compliance operational strategies by evaluating trends; establishing critical measurements; determining production, productivity, quality, and customer-service strategies; designing systems; accumulating resources; resolving problems; implementing change

·       Develops compliance strategies by estimating, forecasting, and anticipating requirements, trends, and variances; aligning monetary resources; developing action plans; measuring and analyzing results; initiating corrective actions; minimizing the impact of variances

·       Protects assets by establishing credentialing and compliance standards; anticipating emerging compliance trends; designing improvements to internal control structure

·       Avoids legal challenges by understanding current and proposed legislation; enforcing regulations; recommending new procedures; complying with legal requirements

·       Attracts new clients by maintaining state-of-the-art credentialing and compliance programs; bringing compliance recognition to the company; providing leadership in the industry

·       Updates job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional organizations

·       Enhances credentialing, compliance and organization reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments

 

 

 

 

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