Upvote
Downvote
Manager, Credentialing Operations
Share Job
- Suggest Revision
Full-time
- This position reports to the Associate Director, Credentialing Operations.
- Collaboration Opportunities: The Manager, Credentialing Operations collaborates with Provider Data Management (PDM), Market Operations, Shared Service team, and our external business partners to monitor operations, resolve service barriers, develop solutions to improve effectiveness, and identify continuous improvement initiatives to increase service and operational level agreements.
- Prepare key credentialing operational reports for internal and external partners that drive business decisions and impact strategic planning.
- Work with Senior leadership to support certification and accreditation processes with National Committee for Quality Assurance (NCQA)Serve as an expert in the administration and maintenance of credentialing and provider data management systems, including the Council for Affordable Quality Healthcare (CAQH), Credentialing System and proprietary claim systems.
- Three (3) to five (5) years of credentialing and/or provider enrollment leadership experience with physicians, Advance Practice Clinicians (APCs), behavioral health, and/or allied providers, in a fast-paced health care environment (hospital, provider group, health plan) – Required.
Active Job
Updated 8 days agoSimilar Job
Relevance
Active