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Credentialing Specialist

St. Louis, Missouri, United States

Title: Credentialing Specialist 
Practice: Oral Surgery Partners
Location: Remote
Office Hours: 8am to 5pm CST

Position Purpose:

The Director of Integration and Compliance is a critical leadership role responsible for overseeing the planning, execution, and optimization of integration activities across business units, systems, technologies, and processes. This position ensures that new acquisitions are smoothly integrated into the organization’s existing infrastructure while maintaining operational continuity. Of equal importance, this role oversees the compliance program across all OSP locations with support of the Chief Compliance Officer.

Essential Functions

Integration Strategy & Planning:

  • Develop and execute the acquisition integration strategy.
  • Lead the creation of integration roadmaps, timelines, and budgets, ensuring alignment with organizational goals.
  • Evaluate and identify potential integration challenges and provide solutions to mitigate risks.
  • Oversee the integration of people, processes, technology, and systems to achieve operational efficiency and alignment.

Cross-Functional Leadership:

  • Collaborate with senior leadership, business units, administrative support partners to ensure effective coordination across all integration activities.
  • Provide leadership and direction to integration project teams, ensuring clear communication, defined roles, and timely delivery of results.
  • Build strong relationships with new practice and doctor partners to foster a collaborative integration environment.

 Change Management:

  • Lead change management efforts to ensure successful transitions during integrations.
  • Communicate effectively with stakeholders at all levels to manage expectations and reduce resistance to change.
  • Provide training, support, and resources for teams impacted by integration activities.

Risk Management & Compliance:

  • Ensure compliance with regulatory requirements, company policies, and industry best practices during integration processes.
  • Monitor systems and training to ensure compliance with various federal and state regulations across all oral surgery locations, including:
    • CMS (Medicaid and Medicare)
    • State licensure
    • HIPAA
    • DEA
    • OSHA
    • PCI
  • Conduct internal reviews or audits to ensure that compliance processes and procedures are followed.
  • Oversee chart audit process conducted by 3rd Party contractor in conjunction with Clinical Compliance Officer and implement other internal controls to ensure proper coding and documentation for services performed and billed.
  • Provide training and recommended corrective actions when deficiencies are identified.
  • Propose new solutions relating to compliance requirements that impact the company's oral surgery practices.

Performance Tracking & Reporting:

  • Establish and monitor key performance indicators (KPIs) for integration and compliance projects.
  • Track and report on integration progress to senior leadership, providing regular updates and insights on challenges, risks, and milestones.

Best Practices:

  • Drive innovation by identifying new technologies, tools, and processes to streamline integration efforts.
  • Promote the use of best practices across new partner practices to improve efficiency and consistency.
  • Foster strong relationships with surgeons, team members, and the support services teams; actively address the needs of our practices by resolving concerns, responding to feedback, and understanding the financial data.

Qualifications

Education:

  • Bachelor’s degree in healthcare, business administration or related discipline, or equivalent experience.

Experience:

  • 4+ experience in healthcare credentialing - Required 
  • 4+ experience in contract negotiation - Preferred
  • Experience in acquisitive healthcare is a strong plus.

Performance Requirements:

  • Proven experience managing complex integrations involving multiple business units and technologies.
  • Knowledge of state and federal compliance requirements in a healthcare environment.
  • Strong understanding of change management principles and methodologies.
  • Exceptional communication, leadership, and interpersonal skills.
  • Ability to navigate complex organizational structures and drive consensus across diverse teams.
  • Strong analytical, problem-solving, and decision-making abilities.
  • Expertise in project management and relevant software tools
  • Ability to travel heavily for integration or compliance activities, OSP events and other functions.

 

What we do for you:
  • We offer Medical, Dental, and Vision Insurance plans to our full-time employees.
  • Two out of the three medical plans offered include Health Savings Account (HSA) eligibility.
  • Company-paid Life, AD&D and Long-Term Disability coverage.
  • Additional Voluntary Life and AD&D Insurance for you and your family!
  • Voluntary Short-Term Disability Insurance available to you as well
  • Dependent Care Flexible Spending Account (FSA) offered.
  • Immediately begin saving for retirement through our 401(k) starting with very first paycheck!
  • Employer 401(k) contribution and Profit Sharing after six months of employment
  • PTO and 8 Paid holidays for fulltime employees!

 

 

DISCLAIMER

The above statements are intended to describe the general nature and level of the work being performed by people assigned to this work.  This is not an exhaustive list of all duties and responsibilities.  OPS’s management reserves the right to amend and change responsibilities to meet business and organizational needs as necessary. 

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