Essential Job Functions:

• Facilitates implementation and coordination of services.
• Ensures safe, secure, and legal work environment by ensuring that the program is following regulatory practices that comply with HIPAA, OSHA, AHCA and other applicable governmental regulations.
• Demonstrates effective cost management strategies, and coordinates resources.
• Manages the credentialing process for all SMA Healthcare clinical providers, in accordance with regulation and accreditation standards, Federal and State laws, and SMA Healthcare policies.
• Coordinates the management of the credentialing database, ensuring accuracy of data and reporting systems.
• Coordinates the management of the electronic credential’s application, to ensure distribution, receipt, processing, and time delivery.
• Coordinates the management of the expirable process to ensure all clinical provider licenses and certificates remain current, ensuring appropriate notification prior to expiration.
• Contract Negotiation: Negotiates terms and conditions of contracts with payers to secure agreements for the organization.
• Contract Management: Oversees the execution of contracts, ensuring compliance with regulatory guidelines and organizational policies. This includes monitoring contract performance and managing renewals or extensions.
• Understands the role of the interdisciplinary team and encourages participation from all persons involved.
• Produces appropriate reports for internal and external customers as required.
• Ensures that assigned personnel are informed of all pertinent information they need to perform their roles effectively, and that they are held accountable for meeting all applicable administrative standards, practices and requirements.
• Completes accurate and timely performance evaluations on assigned staff.
• Professionally represents the agency to all consumers, and to the public.
• Performs other tasks as required.
  

Qualification Requirements: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Minimum Education and/or Experience: Graduation from an accredited school with a Bachelor's Degree in an area pertinent to the program/department responsibilities, and two years of directly related experience required. One year of experience providing supervision preferred. Additional education, experience, and/or certification may be required per program/department guidelines. As allowed by program/department, a combination of education and experience may be substituted for the degree requirement.

Knowledge/Skills/and Abilities:

• Must be competent in providing leadership to assigned staff, and management of all aspects of the operation of the program.
• Must have excellent communications skills and be able to interact with staff and stakeholders in a professional and diplomatic manner.
• Demonstrates confidentiality and exceptional de-escalation skills.
• Demonstrates knowledge of community referral resources and make appropriate referrals to those resources to meet the needs of clients.
• Demonstrates familiarity with software programs used at SMA, or the ability to learn them in a reasonable period of time.