Credentialing Manager

Job Summary

Detail-oriented and proactive, the remote Credentialing Manager will oversee provider credentialing and enrollment processes, lead a team of specialists, ensure compliance with regulations, and manage relationships with insurance plans.

Key responsibilities

• Maintain compliance with NCQA, URAC, Joint Commission, CMS, and state regulatory guidelines
• Design and audit internal quality control processes to ensure accuracy in provider files
• Oversee the full lifecycle of state-level licensing and manage credentialing database security

Required qualifications

• Minimum of 6+ years of healthcare credentialing experience, including 1-2 years in a supervisory role
• Bachelor's degree in Healthcare Administration, Business Administration, or related field preferred
• CPCS or CPMSM certification is required
• Mastery of CAQH, PECOS, and standard credentialing software
• Exceptional attention to administrative detail and ability to handle confidential information