Director of Operational Support

 Posted 21 days ago
     
5-10 years experience
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AI Summary

Lead and oversee the Credentialing, Authorizations, and Verification of Benefits teams to ensure operational excellence and compliance. Manage multi-site credentialing processes and optimize workflows for prior authorizations to minimize risk.

 

The Director of Operational Support will lead and oversee the Credentialing, Authorizations, and Verification of Benefits (VOBE) teams to ensure operational excellence and compliance across all sites. This role is critical in maintaining timely credentialing processes and ensuring active authorizations for all active clients. The ideal candidate will have strong leadership skills, a deep understanding of multi-site credentialing, and experience managing prior authorizations and benefit verification workflows.

Responsibilities

Job Duties and Responsibilities include the following.  Other duties may be assigned.

 

Leadership & Oversight: 

  • Direct and manage Credentialing, Authorizations, and VOBE teams to achieve departmental goals.
  • Provide strategic guidance and operational support to ensure efficiency and compliance.
  • Develop and streamline process and procedures 

Credentialing Management: 

  • Oversee multisite credentialing processes for providers and facilities.
  • Ensure credentialing timelines are met and maintain accurate records for all active providers.
  • Oversee the Delegated Credentialing committee and related activities
  • Provide routine reporting to the field and leadership teams

Authorizations & VOBE: 

  • Ensure active authorizations are in place for all active clients.
  • Monitor and optimize workflows for prior authorizations and benefit verifications.
  • Monitor pending authorization levels to minimize risk

Compliance & Quality Assurance: 

  • Maintain adherence to regulatory and payer requirements.
  • Implement quality control measures to minimize errors and delays.

Reporting & Metrics: 

  • Track and report key performance indicators related to credentialing and authorizations.
  • Identify process improvement opportunities and implement best practices.

Qualifications

Education/Experience: Bachelor’s degree in Healthcare Administration, Business, or related field (Master’s preferred). Minimum 5–7 years of experience in healthcare operations, credentialing, and authorizations. Proven experience with multi-site credentialing processes. Prior experience managing benefit verification and authorization teams strongly preferred

 

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