Credentialing Manager

A company is looking for a Credentialing Manager to oversee credentialing and enrollment processes within Medicaid programs and Managed Care Organizations.

Key Responsibilities

Oversee the end-to-end credentialing and enrollment processes for state Medicaid programs and MCOs

Manage the preparation and submission of enrollment applications, ensuring compliance with state-specific requirements

Develop and maintain policies and procedures for organizational credentialing and support audits related to enrollment

Required Qualifications

Bachelor's degree required; advanced degree preferred

5+ years of relevant work experience in organizational credentialing, provider enrollment, or compliance

Experience managing enrollments with state agencies and MCOs, including application preparation and revalidation

Familiarity with fiscal intermediary operations and government contracts preferred

Certification as a Certified Provider Credentialing Specialist (CPCS) or equivalent preferred