Chief Compliance Officer and Credentialing Manager
HealthCare Recruiters International - Chicago, IL
Apply NowJob Description
Chief Compliance Officer and Credentialing ManagerChicago, ILThe Chief Compliance Officer and Credentialing Manager is responsible for the day-to-day management of the organization's compliance program and provider credentialing department. The essential functions of this position include but are not limited to:Serving as chair of the organization's compliance committee. This includes developing agendas and meeting materials and ensuring meetings are properly documented.Ensure compliance and privacy policies and procedures reflect current regulatory standards and industry guidance. Collaborate with Regional and Office managers to ensure policies and procedures are effectively implemented across all applicable business lines.Collaborate with various leaders to conduct compliance investigations. Keep owners and key stake holders up to date with the results of such investigations.Serve as a resource for clinical and administrative leadership on compliance policies and related matters, including but not limited to evaluation of compliance risk associated with various business initiatives.Day to day management and oversight of the organization's peer review/chart audit function. Ensure chart reviews meet the guidelines established by the compliance committee and clinical leadership. Address and/or escalate concerns identified in the chart reviews.Ensure quality matters are properly addressed and accounted for in the provider credentialing system.Day to day oversite of the provider enrollment and credentialing function and chair of the credentialing committee. Ensure organizational policies and performance metrics are met while establishing positive relationships with new employee dentists.Address bottlenecks in the credentialing process through collaboration with insurance company management personnel and provider relations team members.The ideal candidate will be a solution-focused problem solver with:At least 5 years of healthcare compliance program experience, preferably in a multi-site dental or medical office setting.Demonstrated track record of effectively working with administrative and clinical leadership to accomplish various compliance program-related matters (investigations, initiatives, policy development, etc.)Ability to work independently to identify bottlenecks in processes and create solutions to increase the efficiency and effectiveness of business processes.
Created: 2024-10-03