We are seeking a Director, Credentialing & Licensing to lead the team that manages day-day operations, and process improvement for these important services for clinicians (ex. MD, NP, PA, LCSW, RD, PharmD) at Cityblock Health. You will also lead development of new processes, such as hospital privileging and licensing of different types of clinicians. This is an exceptional opportunity for a process-oriented, self-starter who is interested in leading a cross-functional team at a young, rapidly scaling organization.
The optimal candidate has a strong ability to set direction, align resources and deliver results by working through others. If you like building solutions to advance company performance, and are excited about joining an organization that will drive significant change in the healthcare industry, we want to hear from you!
Lead the Credentialing & Licensing function, which includes:
Seamless and organized management of provider credentialing and licensing processes
Identify gaps in the overall structure/process and proactively implement solutions to improve efficiency and provider experience
Manage key relationships with Cityblock Market and Clinical leaders, Compliance, HR and health plan partners
Define the vendor strategy and serve as business owner of the relationship
Oversee day-day management and work allocation across Credentialing Sr Associates and Licensing Coordinators
Enable new market growth as Cityblock scales nationally by leading successful implementations
Other functions as defined.
How We Define Success:
Achieve Credentialing & Licensing SLAs for new and existing providers across markets
Scalable structure in place for timely licensing and credentialing processing, communications, and tracking mechanism to position Cityblock for delegated credentialing over time
Strong, trusting relationships built with internal team members, cross-functional stakeholders, and health plan partner counterparts
Identification of necessary external systems required for comprehensive credentialing function
Requirements for the Role:
5+ years of management experience with demonstrated results as the leader of Credentialing & Licensing or related health plan operations functions.
3+ years of experience in Medicare, ACA, Marketplace lines of business
You will have 5+ years of experience in Excel and data reporting tools.
You have experience with to value-based care models and the national payer and risk-bearing provider landscape
Proven ability to develop roadmaps and project plans to identity, implement & track projects & quality improvement initiatives
You are a strong people manager that can appropriately balance effective delivery on goals as well as strong professional development for direct reports and their teams
You are aligned to the Cityblock mission and dedicated to building a diverse, equitable, and inclusive team
Nice to Have, But Not Required:
Licensed Notary Public
Experience with Google Suite
Prior experience working in a start-up setting
Strong knowledge of NCQA credentialing requirements and certified programs
Cityblock Health aims to build a scalable solution to address the root causes of health for underserved urban populations.
We partner with provider organizations, health plans, community social services agencies and communities themselves to ensure Medicaid and lower-income Medicare beneficiaries have access to high-value, readily available personalized health services. To do this, we will apply leading-edge care models that fully integrate primary care, behavioral health, and social services. And we will use our custom-built technology to enhance strong relationships between members and care teams, while simultaneously empowering and incentivizing the health system to do better.