Credentialing Manager

Our client is non-profit organization that aims to improve healthcare access to communities. The company represents a network of more than 20 community health centers and more than 65 satellite clinics that provide comprehensive and affordable healthcare services to people in need, and works with its member community health centers to promote the highest standards of care, clinical, financial, and operational excellence.

We are seeking a highly detail-oriented and organized individual for the role of Credentialing Manager. This position will manage our organization's credentialing process, ensuring that our external providers meet all required qualifications and standards.

Duties and Responsibilities:

• Develop and execute a comprehensive credentialing program for contracted providers, in accordance with industry standards and company policies.
• Collect, verify, and maintain all required documentation from external providers, including licenses, certifications, and background checks.
• Develop a database of provider credentials, ensuring accuracy and completeness, and manage ongoing updates as required.
• Conduct audits to ensure compliance with regulations and company policies and procedures.
• Work closely with internal stakeholders to assess credentialing requirements and manage credentialing timelines.
• Collaborate with credentialing committees, medical directors, and other stakeholders, as needed to manage credentialing and re-credentialing.
• Review, analyze, and make recommendations regarding the qualifications and credentials of external providers.
• Maintain a high degree of accuracy and attention to detail in credentialing data management.
• Respond to inquiries and provide updates to internal and external stakeholders pertaining to credentialing.
• Stay up-to-date with evolving regulations and industry standards related to provider credentialing.

Qualifications:

• Bachelor's degree in healthcare administration, business, or a related field
• 3-5 years of experience in credentialing, preferably in a healthcare setting
• Extensive knowledge of industry standards and regulations related to provider credentialing
• Strong organizational, analytical, and problem-solving skills
• Excellent verbal and written communication skills
• Proficiency in Microsoft Office and database management