About Medallion

Healthcare is going through an unprecedented transformation towards digital care. Medallion provides the critical administrative infrastructure to make that change possible. Our platform enables organizations to license their providers in new states, verify existing credentials, and get in-network with health plans. In just over three years, our platform has become an industry standard powering hundreds of healthcare companies to reduce administrative burden for tens of thousands of providers across the country. To date, Medallion has saved over 500,000 administrative hours for our customers!

Founded in 2020, Medallion has raised $85M from world-class investors like Sequoia Capital, Google Ventures, Spark Capital, Optum Ventures, and Salesforce Ventures.

About the role

As Medallion’s Privileging Lead, you will play a crucial role in the leadership of our Privileging team. Our Privileging Team is core to our business and is responsible for ensuring that providers are credentialed and privileged efficiently and accurately. 

We're looking for optimistic self-starters who excel both independently and in team environments. If you’re passionate about privileging multiple provider types and eager to help improve our processes, we’d love to hear from you! 

Compensation for this role is between $59,000 - $83,000 depending on location and level.

What you'll do

• Collaborate with Medical Staff Offices to facilitate provider privileging processes.
• Conduct comprehensive verifications of provider history, including:
• • Work History (Employment): Verify where the provider worked, whether directly at a hospital or through a provider group.
  • Hospital Affiliation: Confirm privileges to practice and provide care at specific hospitals.
  • Claims History: Ensure the provider's claims history aligns with credentialing requirements.
  • Education and Licensure: Verify all degrees, certifications, and licenses, adhering to timeframe requirements (e.g., 5 years, 10 years, or entirety of history as applicable).
• Differentiate and align work history (employment) with hospital affiliation to ensure accurate representation of provider practice and privileges.
• Perform 10-year (or specified timeframe) primary source verification (PSV) processes for hospital affiliation, work history, education, claims history, and licensure.
• Review, manage, and submit Delineation of Privileges (DOP) forms for providers.
• Handle inquiries from hospital privileges committees and resolve discrepancies in provider history or documentation.
• Work with various provider types, including physicians and advanced practitioners, to ensure accurate and complete privileging.
• Maintain detailed records of correspondence and verifications during the privileging process.
• Weekly 1:1 with your team to review performance
• Monitor SLAs to ensure the team is performing within set margins
• Resolve day-to-day questions and blockers for your team and escalate priority issues when needed
• Assess daily workload of team and distribute based on volume
• Communicate clear instructions and be responsive to providers in a timely and professional manner
• Resolve issues that involve people, things, and processes by using logic, collaboration and critical thinking
• Support the team in understanding how specific tasks & initiatives layer up to broader company goals & objectives
• Other duties as assigned

Qualifications

• Proven experience in privileging providers, with expertise in verifying hospital affiliations, work history, education, licensure, and claims history.
• Clear understanding of the distinction between hospital affiliation and work history (employment):
• • Work History: The provider's employment, whether directly at the hospital or through a group.
  • Hospital Affiliation: The provider's privileges to practice at specific hospitals.
• Strong knowledge of Delineation of Privileges (DOP) management and submission.
• Experience conducting primary source verifications (PSV) for various aspects of provider history and aligning them across records.
• Familiarity with timeframe requirements (e.g., 5 years, 10 years, or entirety of history) for different types of verifications.
• Exceptional problem-solving skills to address issues during the verification process or raised by hospital medical staff offices
• Strong organizational and communication skills to ensure accurate documentation and effective collaboration.
• 2+ years of experience managing people in a fast-paced environment
• Conduct yourself in a professional manner when interacting with providers and Medallion clients
• Familiarity with multiple provider types is a bonus 
• Expertise in using GSuites tools include GSheets, GDocs, and GMail