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Robert Half is partnering with a healthcare company known for providing integrated services to 15 affiliates across 19 different states. Part of providing these integrated services is the team behind the Credentialing Services. Robert Half is currently hiring for a Credentialing Manager and we are seeking a strong managerial profile with experience supporting, restabilizing, and repairing teams with renewed leadership support in addition to having not only provider enrollment but payer enrollment.
Job Responsibility:
Coordinate and manage provider credentialing and payer enrollment processes, ensuring all policies and procedures are followed
Maintain and enhance the internal credentialing database for accuracy, renewals, and reporting
Oversee the management of provider licenses, certificates, and credentialing documents, ensuring timely renewals and proper notifications
Track and report on application turnaround times and facilitate credentialing audits as needed
Supervise and support the credentialing team, providing training, allocating work, ensuring policy compliance, and resolving issues
Ensure credentialing records (e.g., NPPES, PECOS, CAQH) are up-to-date for all providers
Foster compliance with organizational, state, and federal requirements, and uphold health equity and racial equity values throughout credentialing practices
Requirements:
Proven experience in a credentialing specialist or credentialing management role
People management experience: task allocation, training/coaching, performance management, and workflow quality review
Strong audit preparation and execution background
Excellent communication and stakeholder management skills
Commitment to health equity, racial equity, and continuous self-learning
Modio credentialing platform experience is required
Advanced experience with credentialing software, including CAQH, NPPES, PECOS, and payer/facility enrollment workflows (Medicare/Medicaid)
Intermediate Microsoft Excel skills for tracking and reporting
Deep knowledge of PSV and payor enrollment best practices
Ability to quickly learn/optimize workflow processes and ensure compliance
What we offer:
medical, vision, dental, and life and disability insurance