Senior Manager of Healthcare Operations

2 weeks ago

Noida, Uttar Pradesh, India beBeeCredentialing Full time US$ 1,00,000 - US$ 1,50,000
Job Title: Team Leader – Credentialing

The primary objective of this role is to oversee and manage a credentialing team, ensuring timely and accurate provider enrollment and re-credentialing.

Key Responsibilities:

  • Lead and supervise daily operations of the credentialing team, adhering to client, payer, and regulatory guidelines.
  • Manage end-to-end provider enrollment and re-credentialing processes with insurance networks, hospitals, and healthcare facilities.
  • Review provider documentation for accuracy, completeness, and compliance prior to submission.
  • Monitor turnaround times and ensure timely completion of credentialing tasks.
  • Serve as the primary escalation point for complex credentialing issues, collaborating with payers and providers for resolution.
  • Train, mentor, and evaluate team members to uphold quality standards and meet productivity goals.
  • Generate and analyze reports on credentialing status, performance metrics, and compliance indicators.
  • Coordinate with internal departments, clients, and third-party entities to streamline credentialing workflows.
  • Stay updated on payer policies, NCQA standards, and healthcare compliance regulations.

Mandatory Skills:

  • Credentialing Expertise: Strong expertise in Credentialing, Provider Enrollment, and US Healthcare Regulations.
  • Leadership Capabilities: Proven leadership and team management capabilities.
  • Communication and Problem-Solving: Excellent communication and problem-solving skills.
  • Credentialing Software Proficiency: Proficiency in credentialing software and reporting tools.

Requirements:

  • Experience: 6–10 Years
  • Employment Type: Full-Time

This position requires strong leadership, process optimization, and stakeholder management skills to maintain high levels of quality and client satisfaction. A successful candidate will have a proven track record of leading teams, managing multiple priorities, and driving results-oriented solutions.

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