Director, Credentialing: National Payor Strategy & Operations

Tenet Healthcare; Dallas (TX); On-site; USD 120,000 - 160,000; Full time

Job summary

Tenet Healthcare is seeking a Credentialing Director to lead provider credentialing and service operations for a US and Philippines-based network. You will interface with legal, revenue cycle, compliance, regulatory accreditation, and managed care while overseeing credentialing systems and CAQH submissions for physicians and allied health professionals.

Responsibilities include creating delegated credentialing agreements, performing root cause denial analysis, and advising on accounts receivable

Qualifications

• Bachelor’s degree or equivalent work history required; MBA preferred.
• Ten years of service operations experience with proximate and distal workforce.
• Five years of supervisory experience with strong management skills.
• Excellent written and oral communication skills.
• Working knowledge of Word and Excel; HIPAA/JCAHO/NCQA knowledge.
• Experience with automation tools (RPA, ML, AI) is a plus.

Responsibilities

• Defines payor credentialing strategy nationally.
• Lead and prioritize team efforts to meet provider start dates.
• Oversee credentialing systems and databases for accuracy.
• Collaborate with legal, revenue cycle, compliance and managed care.
• Maintain NCQA accreditation and delegated credentialing agreements.

Skills

Communication

Teamwork

Management

Time management

Education

Bachelor’s degree or equivalent work history

MBA

Tools

Microsoft Word

Microsoft Excel

Job description

Tenet Healthcare is seeking a Credentialing Director to lead provider credentialing and service operations for a US and Philippines-based network. You will interface with legal, revenue cycle, compliance, regulatory accreditation, and managed care while overseeing credentialing systems and CAQH submissions for physicians and allied health professionals.

Responsibilities include creating delegated credentialing agreements, performing root cause denial analysis, and advising on accounts receivable