Healthcare Credentialing Manager

Healthcare Credentialing Manager

Our client is a prominent healthcare network, specializing in treatment centers and telehealth services. Renowned for their exceptional patient care, they are committed to maintaining the highest standards in the industry.

They are currently seeking a dedicated Healthcare Credentialing Manager to oversee and enhance their credentialing processes, ensuring compliance and efficiency.

The Healthcare Credentialing Manager will spearhead the comprehensive provider verification process, guaranteeing meticulous execution and timely completion of all certification and privileging activities.

This role requires strong organizational skills, attention to detail, and the ability to work in a fast-paced environment.

The ideal candidate will have extensive experience in credentialing, particularly with government and commercial insurance providers, and will be adept at managing a team to achieve high performance standards.

This Role Offers :

Competitive base salary plus comprehensive benefits, including medical / dental / vision, 401(K), and more.

Award-winning, nationwide company with decades of experience.

Tight-knit culture focused on taking care of their employees.

Ample opportunities for growth and career advancement.

Company centered around integrity, compassion, and respect for their employees and patients alike.

High employee tenure with low red tape culture. They hire professionals and trust their expertise, giving them room to make tangible impacts.

Focus :

Manage all credentialing tasks, ensuring timely and accurate completion of applications.

Train, supervise, and coordinate with HR for recruitment, ensuring high performance standards.

Maintain and update credentialing documentation and provider information in the system.

Monitor application statuses, follow up for approvals, and resolve issues or delays.

Respond to client inquiries, communicate timelines, and liaise with carriers across states.

Generate and submit weekly status reports to providers.

Review and enhance internal processes for efficiency and compliance.

Handle escalations, troubleshoot software and carrier system issues, and ensure compliance with requirements.

Skill Set :

Bachelor’s Degree in a related field or equivalent hands-on experience.

Demonstrated track record of at least five years in provider qualification verification, showcasing proficiency in both public sector and private payer enrollment procedures.

Previous management experience required.

Expertise in Microsoft Office Suite, particularly Excel, along with other pertinent software applications.

Excellent verbal and written communication skills.

Strong organizational skills, attention to detail, and ability to manage multiple tasks in a fast-paced environment.