Quality Compliance Manager
$60,800–$76,000 year
On-site · Yonkers, New York, United States
Job Summary
The Quality Compliance Manager oversees the Quality Compliance program related to the credentialing and privileging process of the Medical and Allied health staff for all Montefiore Health System entities, ensuring consistency, accuracy and regulatory compliance with established protocols. Supervises regulatory and delegated health plan surveys and audits (e.g., Joint Commission, CMS, DOH, NCQA) and all delegated health plan requirements. Requires a Bachelor's degree with 5 years of experience; background in Academic Medical Centers or multi-entity health systems and credentialing/ payor enrollment; NAMSS CPCS preferred. Proficiency in credentialing software and systems and a strong understanding of applicable state, federal, and accreditation standards is essential.
Required Qualifications
- Bachelor's Degree required
- 5 years of experience
- Experience in an Academic Medical Center, Multi-entity health system
- Experience in Medical Staff Credentialing and Privileging and payor enrollment
- Strong understanding of state, federal and accreditation standards (NCQA, TJC, CMS) related to credentialing and enrollment
- Proficiency in credentialing specific software and systems
- NAMSS certified provider credentialing specialist (CPCS) preferred
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