Provider Credentialing Manager

Job Summary

A company is looking for a Provider Credentialing & Enrollment Manager.

Key Responsibilities

• Oversee the processing of applications and reapplications for providers, ensuring compliance with accreditation standards and regulations
• Develop and implement policies and procedures for credentialing and recredentialing processes
• Manage primary source verification of healthcare providers' education, training, and licensure

Required Qualifications

• Minimum of five (5) years of experience in provider credentialing and enrollment in an outpatient setting
• Expertise in state bylaws governing credentialing processes for urgent care or multi-site health systems
• Knowledge of the healthcare industry or medical financial operations
• Experience with CAQH (Council for Affordable Quality Healthcare) database and application process
• Ability to maintain accurate provider credentialing information in the database