Credentialing Manager

Job Summary

A company is looking for a Credentialing Manager to oversee the credentialing process for healthcare providers.

Key Responsibilities

• Manage end-to-end credentialing, recredentialing, and payer enrollment for healthcare providers
• Ensure compliance with NCQA, CMS, state, and payer-specific credentialing standards
• Track and communicate credentialing timelines to support provider onboarding and avoid revenue delays

Required Qualifications

• Bachelor's degree or equivalent healthcare experience
• At least 5 years of experience in healthcare credentialing
• NAMSS certifications (CPCS, CPMSM, CPES) preferred
• Experience managing delegated credentialing programs independently
• Strong understanding of commercial, Medicare, and Medicaid credentialing requirements