Credentialing Manager

Job Summary

A company is looking for an Associate Manager-Credentialing to oversee the Credentialing department and ensure compliance with performance standards.

Key Responsibilities

• Manage the practitioner credentialing function, ensuring compliance and monitoring performance
• Supervise and train credentialing staff, providing resources and support as needed
• Create and revise credentialing policies and procedures to ensure regulatory compliance

Required Qualifications

• Bachelor's Degree in Business, Health Administration, Public Administration, or equivalent experience required
• 4 years of progressive experience and 2 years of supervisory experience required
• Familiarity with specialty health plans (HMO, PPO, POS) required
• Knowledge of Credentialing/re-credentialing, NCQA, and URAC required
• Proficient with Microsoft Office applications