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Credentialing Account Manager

RLDatix

RLDatix

Sales & Business Development
United States · Remote
Posted on Friday, June 28, 2024

Every single day around the world, thousands of patients are harmed from care delivery errors, many of which are preventable. We want to change that. RLDatix is on a mission to improve healthcare by enabling a world where patients receive the best and safest care possible. Trusted by thousands of clients around the world, our connected healthcare operations platform combines software and trusted services to empower organizations with critical data insights across risk, safety, compliance, provider lifecycle and workforce management. Our user-centric approach provides a holistic, real-time view of healthcare operations, connecting disparate information across the enterprise – thus giving organizational leadership the contextualized data they need to make better informed decisions.

RLDatix is truly global, with over 2,000 employees across the UK, Europe, Middle East, Australia, Canada, and the United States. Our strategy is fueled by organic and inorganic growth that brings together the brightest minds and the latest technology – including AI - to deliver marketing leading solutions for our clients. We are looking for people to join our team who are passionate about making a positive change in healthcare. Join us as we work towards our vision of safer, better healthcare for all.

In line with our mission, we are looking to recruit a Credentialing Account Manager on our Credentialing team.

What You Will Do:

· Act as the main point of contact for clients, liaising with all levels from Medical Staff, Office Managers & Directors, Auditors & Surveyors, Dept Chairs and Chiefs

· Own the day-to-day communications – in system, phone and email, reports, statuses, escalations.

· Manage priorities between provider day to day maintenance making certain that applications (initial, reappointment, change in privilege, etc.) are prioritized and delegated appropriately.

· Monitor Medical Staff Leadership and Delegate reviews, following up on comments and questions as needed; maintaining committee rosters and ensuring all applications are presented in a timely manner.

Key Responsibilities

Application Quality Review

• Use industry knowledge to evaluate application for accuracy, compliance, and completeness.

• Perform final quality review and advance all applications to the client.

• Create and assign quality tickets in Zendesk.

• Follow‐up on client review comments and necessary investigations.

• Monitor pending verifications and application issues through final approval.

• Create and distribute comments & investigations report and committee rosters.

• Complete File Close Out Process

Client Service

• Provide quality client service (internal and external) to all levels of personnel.

• Perform client user training as needed.

• Utilize critical thinking to resolve support and client questions.

• Submit, track, and test reported defects and technical client requests to leadership

• Collaborate with teammates to ensure client needs are met.

Client Management

• Create and maintain successful client relationships

• Lead weekly client coordination calls

• Monitor ongoing client application deadlines and expirations

• Communicate status of applications and expiring records to client

• Distribute monthly application notices to Medical Staff Leadership

• Manage special client projects as needed

• Monitor client utilization and drive engagement within the software

• Participate in new client implementation meetings as assigned

• Track and log monthly practitioner count and expedited applications

Experience/Knowledge/Competencies You Will Need:

· Three years minimum experience with Provider Privileging

· Advanced knowledge of NCQA and/or TJC Accreditation standards

· CPMSC/CPCS Certification preferred.

· Advanced skills in database management

· Working knowledge of clinical and/or medical staff office hospital operations and procedures.

· Capable of handling sensitive and confidential information appropriately

· Excellent client service skills

· Strong communication skills, ability to communicate effectively with internal and external stakeholders.

· Strong ability to prioritize and meet deadlines.

· Strong judgment and critical thinking skills

RLDatix is an equal opportunity employer, and our employment decisions are made without regard to race, color, religion, age, gender, national origin, disability, handicap, marital status or any other status or condition protected by Federal and/or State laws.

RLDatix offers a competitive compensation package and comprehensive benefits package including health, dental, vision, life, disability coverage, a generous retirement savings plan, paid time off, and paid holidays. RLDatix is an equal opportunity employer, and our employment decisions are made without regard to race, color, religion, age, gender, national origin, disability, handicap, marital status or any other status or condition protected by Federal and/or State laws.