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Credentialing Manager

Location:Laredo, TX
Salary Range:DOE
Employment Type:Full Time
Positions Needed:1
Description:Responsible for coordinating the credentialing of licensed and certified staff and the employment of non-licensed and non-certified staff as a function of the Center’s Compliance, Performance Improvement and Risk Management (CPIRM) Committee. Establishes the application and credentialing file for each applicant and conducts the verification, investigation, and compiles documents to justify the recommendations by the CPIRM or Professional Review Committee (PRC) concerning granting of privileges and employment of potential staff.

SUPERVISION: Directly supervised by the Chief Operating Officer for administrative related matters and the Chief Medical Officer for medically related matters.

TYPICAL PHYSICAL DEMANDS: Requires prolonged sitting, stooping and bending. May require moving up to 25 pounds. Requires the use of office equipment, such as computer terminals, telephone and copiers. Travel may be required.
Duties:• Follows and updates as required the TACHC credentialing manual, to establish procedures and time frames for implementing the Center’s credentialing program.
• Monitors and evaluates the Center’s relevant employment and credentialing policies and procedures and makes suggestions for improvement, as needed.
• Receives and verifies applications for credentials and initiates references and validation of the applicant’s qualifications, competency, and scope of practice.
• Conducts or assists with investigation of adverse or missing information.
• Coordinates credentialing correspondence.
• Manages and maintains a current checklist for each application file concerning its status (e.g., provider license renewals to include FTCA listing).
• Consults with the CPIRM Committee and appropriate administrative and clinical staff concerning special issues relating to credentialing to assure appropriate process.
• Advises applicants on the application process and on the status of their applications and information needed to complete the credentialing files.
• Manage all credentialing files to be current and in compliance.
• Knowledgeable of the requirements for employment, credentialing, and re-credentialing of licensed and certified health care providers for compliance with the law, including FTCA, Joint Commission and other applicable entities.
• Knowledgeable of state and federal laws (including but not limited to Title VII of the Civil Rights Act of 1964, the Rehabilitation Act of 1973, The Age Discrimination and Employment Act, Texas Commission on Human Rights Act, and the Americans with Disabilities Act).
• Maintains confidentiality of credentials and employment process.
• Responsible for completion of and accuracy of “Review of Credentialing Systems” section within annual FTCA application.
• Performs other duties as assigned.
Qualifications:• Graduate from an accredited high school or GED program.
• Bachelor’s degree from an accredited college or university in business management, human resources or related field OR five years of experience in a healthcare related field.
• Audit and investigatory skills.
• Experience in maintaining confidentiality.
• Strong interpersonal skills.
• Two years’ experience in a healthcare-related administrative/secretarial/clerical position preferred.
• Bilingual in English and Spanish preferred.

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