Healthcare Credentialing Operations Manager
3 hours ago
This is a detail-oriented and organized individual role that involves managing the full-cycle credentialing and re-credentialing process for healthcare providers. The ideal candidate will have experience in managing provider enrollment, credentialing, and compliance with regulatory guidelines.
- Key Responsibilities:
- Verify and maintain provider documentation, licenses, certifications, and affiliations.
- Coordinate with insurance companies, hospitals, and healthcare organizations for provider enrollment.
- Ensure compliance with NCQA, CMS, and other regulatory requirements.
- Maintain accurate and up-to-date records in credentialing databases.
- Communicate effectively with providers regarding application status, missing information, or required updates.
- Support audits, reporting, and quality improvement initiatives.
- Minimum 1 year of hands-on experience in healthcare credentialing or provider services.
- Familiarity with credentialing software/systems (CAQH, NPPES, PECOS, etc.).
- Excellent organizational and documentation skills.
The successful candidate will be able to work collaboratively with providers, payers, and internal teams to ensure seamless credentialing processes.
We are seeking a highly skilled and motivated individual to fill this key role within our organization. If you have a strong background in healthcare credentialing and excellent communication skills, we encourage you to apply for this exciting opportunity.
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