Senior Manager, Credentialing

Job Summary

Overseeing all credentialing and provider data management processes, the full-time Senior Manager, Credentialing will manage provider enrollment and data maintenance in a remote capacity while ensuring compliance with regulatory standards.

Key responsibilities

• Direct oversight of credentialing and re-credentialing for physicians and organizational providers
• Manage the development of training materials, policies, and procedures related to provider data management
• Ensure compliance with NCQA credentialing standards and health plan policies regarding provider records

Required qualifications

• Bachelor's degree or equivalent experience
• 4 years of relevant experience in credentialing and provider data management
• 3+ years of supervisory or management experience
• Knowledge of NCQA standards and state/federal regulations
• Preferred experience with Portico, Amisys, or CenProv systems