Hi, I’m
MOHAMMAD HASSAN
Irvine,California
Summary
Seasoned Credentialing Leader with over 20 years of experience in healthcare credentialing, project management, and business development. Proven expertise in strategic planning, regulatory compliance, and operational excellence. Adept at leading teams, optimizing processes, and ensuring adherence to NCQA, Joint Commission, and CMS standards. Demonstrated ability to drive operational excellence, enhance client experience, and achieve organizational goals.
Overview
28
years of professional experience
1
Certification
Work History
East Valley Community Health Center
Credentialing Manager
2021.06 - Current (3 years & 3 months)
Job overview
- Developed and implemented strategic vision for credentialing function, aligning with organizational goals
- Provided leadership and direction to credentialing team, fostering culture of excellence and continuous improvement
- Ensured compliance with regulatory requirements, including FPPE and OPPE Joint Commission standards
- Created industry-leading client experience characterized by flawless execution and transparency in credentialing process
- Stayed abreast of regulatory changes, accreditation standards, and industry best practices
- Evaluated existing credentialing processes and workflows, identifying opportunities for optimization and efficiency enhancement
- Established quality assurance measures and performance metrics to monitor accuracy and completeness of credentialing activities
- Collaborated with executive leadership and cross-functional teams to ensure alignment and support for credentialing initiatives
- Oversaw relationships with external vendors and credentialing organizations, ensuring effective collaboration and adherence to service level agreements
- Developed and managed budget for credentialing department, ensuring efficient allocation of resources.
e2o Health Inc
Credentialing & Project Manager
2016.06 - 2021.12 (5 years & 6 months)
Job overview
- Directed credentialing, enrollment, and audit processes, ensuring compliance with NCQA standards
- Enhanced application processes to improve workflow and data quality
- Implemented process improvements, optimizing operational efficiency and reducing costs
- Collaborated cross-functionally to streamline credentialing activities and manage information flow
- Maintained up-to-date provider data, ensuring timely renewals and data security
- Evaluated vendor performance and negotiated contracts to optimize value and quality.
Tenet Healthcare
Business Development Manager
1996.01 - 2015.12 (19 years & 11 months)
Job overview
- Oversaw business development and healthcare billing operations, maintaining compliance with CMS regulations
- Built and maintained relationships with providers, payers, and stakeholders
- Developed strategies to improve healthcare services and operational efficiency
- Ensured client records were maintained according to agency standards, policies, and procedures
- Identified operational problems and implemented process improvements.
Education
Orange Coast College , Costa Mesa, CA
Health Information Technology (HIT)
01.2012
California State University, Long Beach , Long Beach, CA
Bachelor of Science in Business Administration & Marketing
01.2001
Skills
- Strategic Planning & Execution
- Regulatory Compliance (NCQA, Joint Commission, CMS)
- Team Leadership & Development
- Credentialing Process Optimization
- Vendor Management & Contract Negotiation
- Data-Driven Decision Making
- Quality Assurance & Performance Metrics
- Cross-Functional Collaboration
- Client Experience Enhancement
- Budget Management & Resource Allocation
- Credentialing Software Expertise
- Data Research & Analysis
- Project Management Tools
Certification
- Candidate for NAMSS CPMSM
- Medical Billing Certification, Santiago Canyon College, Orange, California
- Lean Six Sigma Green Belt Certification
Timeline
Credentialing Manager
East Valley Community Health Center
2021.06 - Current (3 years & 3 months)
Credentialing & Project Manager
e2o Health Inc
2016.06 - 2021.12 (5 years & 6 months)
Business Development Manager
Tenet Healthcare
1996.01 - 2015.12 (19 years & 11 months)
Orange Coast College
Health Information Technology (HIT)
California State University, Long Beach
Bachelor of Science in Business Administration & Marketing
- Candidate for NAMSS CPMSM
- Medical Billing Certification, Santiago Canyon College, Orange, California
- Lean Six Sigma Green Belt Certification
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