Credentialing Program Manager

Job Summary

Managing the end-to-end credentialing and provider enrollment program, the full-time remote Credentialing Program Manager will oversee provider onboarding, maintain compliance with regulatory standards, and enhance credentialing processes while collaborating with cross-functional teams.

Key responsibilities

• Collects and verifies provider credentials, ensuring compliance with regulatory requirements
• Operates the delegated credentialing program, including primary source verification and alignment with industry standards
• Monitors and reports on provider licenses and certifications, managing internal audits for quality assurance

Required qualifications

• Bachelor's degree in a related field and four years of relevant experience or an equivalent combination of education and experience
• Demonstrated experience in healthcare regulatory compliance, credentialing, and provider enrollment
• Strong knowledge of healthcare regulatory requirements and credentialing standards
• Proven ability to manage complex issues and provide timely resolutions
• Advanced computer skills, including proficiency with Microsoft Office applications