Credentialing Manager

• Lead the credentialing team to process provider applications, verifications, and re-credentialing activities in accordance with regulatory, payer, and facility requirements
• Develop, implement, and maintain policies, procedures, and workflow improvements to ensure efficient, compliant credentialing operations
• Oversee initial and ongoing verification of practitioner credentials (education, licensure, certifications, work history, malpractice history, etc.)
• Stay current with state, federal, and accrediting body requirements (e.g., NCQA, Joint Commission) and serve as internal subject matter expert for compliance
• Manage relationships and communications with providers, insurance payers, and internal stakeholders to resolve credentialing issues and expedite enrollment
• Prepare for and participate in audits, surveys, and quality assurance reviews
• ensure proper documentation and recordkeeping
• Provide regular reporting and analytics to senior leadership regarding credentialing metrics, provider enrollment status, and workflow efficiency
• Hire, train, and mentor credentialing staff
• foster a culture of accountability and continuous improvement

• Bachelor’s degree in healthcare administration, business, or related field
• 10 years of progressive credentialing experience within the healthcare industry, including experience with supervisory or management
• In-depth knowledge of credentialing standards, regulations, and best practices (NCQA, CMS, Joint Commission, and payer requirements)
• Strong organizational, analytical, and problem-solving skills
• ability to manage multiple priorities under tight deadlines
• Excellent interpersonal and communication skills, both written and verbal
• Proficiency with credentialing systems/software and Microsoft Office Suite

Certification in Medical Staff Services Management (CPCS or CPMSM) is preferred

• competitive salary
• benefits
• generous paid time off
• flexible schedule
• fully remote option
• medical, vision, dental, and life and disability insurance
• eligible to enroll in our company 401(k) plan