State Licensed Credentialing Manager

Job Summary

Overseeing credentialing and accreditation operations, the full-time remote State Licensed Credentialing Manager will manage staff and ensure compliance with NCQA and federal/state regulatory requirements while leading client implementations and quality management initiatives.

Key responsibilities

• Lead and manage credentialing activities to meet NCQA standards and regulatory requirements
• Oversee program delivery and maintenance for NCQA and URAC accreditations, including updates and changes
• Coordinate with cross-functional teams to ensure effective communication and implementation of credentialing processes

Required qualifications

• Current, active, unrestricted state license in the clinical arts (e.g., RN or BSN) is required
• Bachelor's degree in healthcare administration or related field is highly preferred
• Minimum of 5+ years of experience in healthcare operations or managed care roles
• 4+ years of supervisory experience required
• Direct experience with accreditation, certification, and audit activities is required