Key Facts

Remote From:

Full time

Expert & Leadership (>10 years)

English

Hard Skills

Credential Manager Prior Authorization Credential Manager Process Optimization Process Improvement Regulatory Compliance Risk Mitigation Business Operations KPI Reporting Change Management +2 more

Other Skills

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Record Keeping
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Quality Assurance
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Decision Making
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Collaboration
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Communication
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Leadership
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Time Management
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Strategic Planning
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Detail Oriented
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Problem Solving

Roles & Responsibilities

Bachelor’s degree in Healthcare Administration, Business, or related field (Master’s degree preferred).
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.

Requirements:

Lead and manage the Credentialing, Authorizations, and VOBE teams to achieve departmental goals, provide strategic guidance, and streamline processes.
Oversee multisite credentialing for providers and facilities, ensure timely credentialing, maintain accurate records, and manage the Delegated Credentialing committee with routine reporting.
Manage Authorization and VOBE workflows, ensure active authorizations for all active clients, optimize prior authorization and benefit verification processes, and monitor pending levels to minimize risk.
Ensure compliance with regulatory and payer requirements, implement quality assurance measures, and track/report key performance indicators to drive continuous improvement.

BlueSprig

About BlueSprig

At BlueSprig we’re on a mission to change the world for children with autism. The families and children we serve are at the heart of everything we do. Our dedicated team of clinically excellent BCBAs, RBTs, BTs, and administrative staff provide the highest standard of care so that you and your child receive the best ABA treatment available. We have three pillars of commitment to the families and children we serve: Compassionate Care: Our goal is to provide the very best and most compassionate ABA therapy services to all children who need it, regardless of their means. Close to Home: We are community first - we open multiple clinics in a community to provide easier access to care and to be a loud advocate for positive change. Exceptional Results: We aren’t the norm, we never settle for ok, and you shouldn’t either. Our treatment plans are individualized, evidence-based, and research-based so that you can feel confident your child is receiving the best and most compassionate care. At BlueSprig, we talk the talk and walk the walk. Our mission and core values are our foundation. We take them seriously and we live them every day.

Company type: Large

Founded: 2018

Company size: 1001 - 5000

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Job description

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

#OPS

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