Director, Credentialing Compliance

At MTM, we are not just colleagues; we are collaborators on a shared mission; communities without barriers.

We have exciting opportunities to join our growing team where your work has a direct impact on the communities we serve.

Our company culture is one of innovation, collaboration, and growth.

If you are passionate, driven, and ready to join a team where your work will directly transform and shape our industry, then we want to talk to you!

What will your job look like?

The Director, Credentialing Compliance is responsible for developing, executing and managing the compliance processes as it relates to the credentialing functions.  It requires strong judgment skills and business acumen, as the successful management of Credentialing will be achieved by building and maintaining strong relationships with multiple internal and external team members and cross functional groups.

This position will also be responsible for identifying regulatory compliance risks and related issues and partnering with internal teams to determine root cause and resolutions.  The Director, Credentialing Compliance will need strong knowledge of CMS Regulations, client contractual requirements and excellent communication, interpersonal and organizational skills.

Location: This is a hybrid role of work from home and in office at our Lake St.

Louis, MO location.

What you’ll do:


* Regulatory Compliance responsibilities as it relates to the credentialing process, include but are not limited to the following:
+ Prevention of unethical, illegal or improper conduct within the credentialing process
+ Monitoring activities of all aspects of the credentialing compliance requirements to identify possible trends both good and bad
+ Create and maintain policies and procedures to assure compliance with applicable local, state and federal laws, regulations and third-party guidelines
+ Manage audits and investigations into credentialing compliance issues


* Manage, develop and train the Credentialing personnel


* Provides day-to-day oversight, monitoring and analyses of all activities related to Organizational Quality Management in adherence to identified national standards i.e.

National Committee for Quality Assurance (NCQA), Utilization Review Accreditation Committee (URAC) and HITRUST certification


* In concert with other MTM departments organize systematic data collection for analysis and interpretation of transportation and ancillary services and outcomes, including identification of transportation provider patterns and compliance with credentialing standards


* Provide oversight management of Quality Improvement Programs corporate wide


* Successful management of URAC accreditation and ongoing compliance as it relates to the credentialing process


* Promote continuous improvements in quality systems and department infrastructure


* Report significant and/or serious ongoing quality and credentialing ...