SHELDON L KENNEDY
Corona,CA
Summary
Passionate about driving operational excellence within the healthcare field, Bringing strategic expertise in revenue cycle management. Focused on standardization, implementation, and utilization of industry-leading practices. Proven track record in leadership and team building, expertise in credentialing and delegated credentialing practices. Highly motivated to excel in new environments and drive advancement.
Overview
17
17
years of professional experience
Work History
Delegated Credentialing Manager
PDS Health
03.2022 - Current
- Ensure that all healthcare providers within the organization meet necessary qualifications and standards to provide care to patients
- Reduced processing times for credential applications by optimizing workflow efficiency and staff allocation.
- Streamlined credentialing processes by implementing efficient tracking systems and reducing paperwork.
- Led team meetings to discuss progress toward goals, troubleshoot issues, and share best practices among colleagues.
- Developed performance metrics to monitor staff productivity, leading to increased efficiency throughout the department.
- Facilitated smooth communication between departments, fostering collaboration in support of credential management objectives.
- Established strong relationships with external agencies, streamlining communication regarding provider credentials and facility statuses.
- Stay up-to-date with relevant healthcare regulations, accreditation standards (e.g., NCQA, Joint Commission), and payer requirements to ensure that the credentialing process complies with all applicable laws and guidelines
- Oversee the credentialing and re-credentialing of Dental providers
- Managed the onboarding process for new providers, ensuring timely completion of all required documentation.
- Developed comprehensive training materials for new hires, promoting consistency in credentialing processes across the organization.
Delegated Credentialing Supervisor
PDS Health
01.2018 - 03.2022
- Designed and Built the Delegated Credentialing process within the organization
- Ran daily reports to assess performance and make proactive adjustments
- Developed and implemented strategies to drive business success and maintain budgetary guidelines
- Identified pain points requiring immediate improvement and rolled out new programs, boosting productivity 80%
- Prepared departmental contracts for attorney approval
- Addressed credentialing requests, overseeing compliance with governmental and organizational guidelines regarding tiered data access
- Performed primary source verifications such as criminal histories, licenses, and board certifications
- Provided leadership, insight, and mentoring to newly hired employees to supply knowledge of various company programs
- Implemented departmental policies and standards in conjunction with management to streamline internal processes
- Developed strong relationships with external organizations for seamless information exchange during the verification process.
- Enhanced department efficiency by training new staff on credentialing procedures and providing ongoing support.
- Addressed potential issues proactively by conducting root cause analysis investigations specific to any credentialing discrepancies or concerns identified throughout the review process.
- Managed a high volume of provider applications efficiently while adhering to established timelines for completion and approval processes.
- Created detailed reports to track progress, identify trends, and provide valuable insights for continuous improvement efforts within the department.
Life Coach
National Family Life & Education Center
09.2015 - Current
- Assisted clients with developing life management skills and coping mechanisms to handle daily living requirements
- Led group sessions and encouraged discussion to improve results for all individuals
- Helped clients set weekly goals and plan how to accomplish objectives
Manager
Allied Tech Lapping and Polishing
01.2008 - 01.2018
- Restocking, assembly line supervisor, company filing, managing money accounts, job consultant, controlling entry to the facility, answering phones for the company, pick up and delivering, office manager, computer skills, public contact manager, and grind specialist
- Handling maintenance of the facility and its machines, managing custodial services
- Taking care of day-to-day operation, interacting with the public, managing clerical duties
- Coordinated day-to-day and long-term activities within various business platforms
Education
Bachelor of Arts - Business Administration
California Baptist University
Riverside, CAAssociate of Arts - Business Administration
Norco College
Norco, CA01.2015
Skills
- Credentialing Policies & Procedures
- Re credentialing
- Delegated Credentialing
- Managing Processes
- Creating Credentialing policies and Procedures
- Goal-oriented
- Conflict resolution
- Report Generation
- Public speaking
- Time management
- Operational leadership
- Detail-oriented
- Provider enrollment
- Application processing
- Credential verification
- Policy analysis
Additional Information
Awarded Leadership of the Year Award., Under my leadership, my department was awarded Department of the Year., Excelled in leading a remote team.
Timeline
Delegated Credentialing Manager
PDS Health
03.2022 - Current
Delegated Credentialing Supervisor
PDS Health
01.2018 - 03.2022
Life Coach
National Family Life & Education Center
09.2015 - Current
Manager
Allied Tech Lapping and Polishing
01.2008 - 01.2018
Bachelor of Arts - Business Administration
California Baptist University
Associate of Arts - Business Administration
Norco College
Similar Profiles
Melissa RosalesMelissa Rosales
Director, Plan Partnership & Strategy at PDS HealthDirector, Plan Partnership & Strategy at PDS Health
JORGE DE LEÓNJORGE DE LEÓN
Maintenance Coordinator at PDS HealthMaintenance Coordinator at PDS Health
ㅤ ㅤ null
Dental Assistant in Training at PDS Health - Davis Smiles DentistryDental Assistant in Training at PDS Health - Davis Smiles Dentistry