Director Credentialing Operation - Academy of Managed Care Pharmacy : Job Details

All the benefits and perks you need for you and your family:

• Paid Days Off from Day One
• Student Loan Repayment Program
• Career Development
• Whole Person Wellbeing Resources
• Mental Health Resources and Support

Our promise to you:

Joining AdventHealth means being part of a community that believes in the wholeness of each person and serves to uplift others in body, mind, and spirit. AdventHealth is a place where you can thrive professionally and grow spiritually, by extending the Healing Ministry of Christ. You will be valued for who you are and the unique experiences you bring to our purpose-minded team. Together, we are even better.

Schedule: Full Time

Shift: Days

Location: 3100 East Fletcher Avenue, Tampa, Florida 33613

The community you'll be caring for:

• AdventHealth Tampa, a faith-based not-for-profit 626-bed tertiary-level acute care hospital in Tampa, Florida, specializing in cardiovascular medicine, neuroscience, digestive health, orthopedics, women's services, pediatrics, oncology, endocrinology, bariatrics, wound healing, sleep medicine, and general surgery including minimally invasive and robot-assisted procedures. GME programs include general surgery, obstetrics and gynecology, internal medicine, and transitional year.
• Home to the AdventHealth Pepin Heart Institute, a leader in cardiovascular disease prevention, diagnosis, treatment, and research for over 35 years.
• The Kiran C. Patel Research Institute, leading in clinical and academic research in neuroscience, cardiovascular medicine, and surgery.

The role you'll contribute to:

This position involves directing delegated credentialing functions and managing the daily operations of the credentialing and provider enrollment team, including staff selection, training, and supervision. The role emphasizes quality, efficiency, and superior service, ensuring compliance with NCQA and CMS standards. Collaboration with AdventHealth Medical Group, leadership, Managed Care Organizations, and other departments is essential. The role also involves maintaining respectful relationships and providing outstanding customer service.

The value you'll bring to the team:

• Implement follow-up and quality improvement programs for provider onboarding, data collection, processing, and payer follow-up within Florida.
• Oversee credentialing and follow-up for delegated and non-delegated physician groups and payers.
• Coordinate with medical staff and physician organizations to ensure efficient information flow.
• Maintain physician-centric credentialing processes focused on exceptional customer service.
• Guide and oversee the provider data and credentialing team, fostering a positive work environment aligned with AdventHealth's core values.

Qualifications

The expertise and experience you'll need:

• Master's in Business Administration required.
• 10+ years in credentialing within large practice settings, health plans, or medical staff services, with management responsibilities, including delegated credentialing.
• 10+ years in healthcare leadership/management over credentialing.
• Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Staff Management (CPMSM) required, or ability to obtain within 18 months of hire.

This facility is an equal opportunity employer and complies with all anti-discrimination laws. Salary ranges are based on skills, experience, and location.

Category: Medical Staff

Organization: AdventHealth Tampa

Schedule: Full-time

Shift: Day

Req ID: 25022228

We do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age, or disability.