Credentialing Supervisor

Arizona Priority Care (AZPC) is an Integrated Provider Network focused on providing whole-person care to Senior and Medicaid populations, through advanced value-based models. Our provider network is comprised of more than 6,000 health care providers, including primary and specialty care physicians, hospitals and ancillary providers.  We have operated in the Arizona market for more than 12 years, based in Chandler, Arizona, and are an affiliate of Heritage Provider Network. As a leading value-based provider organization, we are committed to improving the quality of care, providing excellent member and provider experiences all while reducing cost.

The Arizona Priority Care (AZPC) Credentialing Supervisor plays a critical role within the organization, overseeing the credentialing process for health care providers to ensure they meet the necessary qualifications and standards to provide care. This position involves the supervision and working alongside the credentialing team, ensuring accurate and efficient processes are in place for verifying the credentials of medical professionals and health delivery organizations. The Credentialing Supervisor is responsible for maintaining up-to-date knowledge of credentialing standards and regulations, and for ensuring that all healthcare providers in AZPC’s network are properly credentialed and recredentialed according to NCQA standards and regulatory requirements.

POSITION DUTIES & RESPONSIBILITIES

• Lead and supervise the credentialing team, providing guidance, training and support to ensure high performance and efficiency.
• Review standard operating processes (SOPs) annually or as needed, for the credentialing department, ensuring compliance with federal, state and NCQA standards.
• Oversee the entire credentialing process, from initial application to approval, including primary source verifications, ongoing monitoring, and assisting with credentialing committee prep.
• Collaborate with internal departments, such as Provider Network, Network Contracting, and Provider Relations, to ensure a seamless credentialing process.
• Maintain accurate and confidential provider credentialing files and databases, ensuring all documentation is up-to-date and compliant i.e., expirables.
• Monitor and ensure timely recredentialing of providers to avoid lapses in credentialing requirements per NCQA standards.
• Stay informed of changes in credentialing standards and regulations, adjusting processes as necessary to maintain compliance.
• Prepare and present reports on credentialing status and activities to management and other stakeholders.
• Resolve any issues that arise during credentialing process efficiently and professionally.
• Serve as the primary contact for the Credentialing department for both internal and external inquiries.
• Participate in audits and accreditations related to credentialing, ensuring the organization meets all required standards.
• Performs other duties as assigned by credentialing management.

EDUCATION, TRAINING AND EXPERIENCE

• High School Diploma or GED (Required)
• Associate Degree in healthcare administration (Preferred)
• A minimum of 3-5 years’ experience in Credentialing, with at least 2 years in a leadership role.
• Strong organizational skills and attention to detail.
• Ability to work under pressure and meet tight deadlines.
• Excellent communication and interpersonal skills, with the ability to work effectively with all levels of staff and external partners.
• Proficiency in Morrisey credentialing databases and software, as well as Microsoft Office Suite.
• Strong knowledge of NCQA Guidelines and State and Federal regulatory requirements.

*This role requires 60 days FT in office presence, hybrid options will be available after the 60-day period.*

Compensation range: The hourly range for this position is: $27 – $30.