Credentialing Manager

Job Summary

A company is looking for a Credentialing Manager to oversee the credentialing process and ensure compliance with regulatory requirements.

Key Responsibilities

• Manage a credentialing staff and oversee the credentialing process for providers and facilities
• Collaborate with technology teams to develop a proprietary credentialing platform and ensure accurate provider data transmission
• Conduct audits and monitor compliance with state and federal standards, ensuring quality and accuracy of provider data

Required Qualifications

• 5+ years of provider credentialing experience and 1 year of supervisory experience
• Strong knowledge of NCQA and/or JCO credentialing standards
• Proficient in credentialing software (e.g., Medallion, CAQH, CredSimple)
• Experience with process improvement initiatives
• Bachelor's Degree or equivalent work experience focused on credentialing