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Provider Services Manager Clinical Licensure Required
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Full-time
- Position in this function is responsible for the full range of provider relations and services interactions including provider recruitment, network development, provider education, provider credentialing and enrollment, processing provider applications and reapplications and contracting.
- The Manager of Provider Services is responsible for the development and management of the Fee for Service (FFS) Medi-Cal and the Treatment and Evaluation Resources Management (TERM) provider networks.
- Implements provider recruitment and contracting, and oversees the updating of data, fee schedules, coding, and billing as applicable
- Oversight of Council for Affordable Quality Healthcare (CAQH) and Credentialing Verification Organization (CVO) monthly invoices for all FFS, TERM and San Diego County Psychiatric Hospital (SDCPH) provider files
- Oversees credentialing, enrollment and contracting processes; update processes as needed to meet National Committee for Quality Assurance (NCQA) or County standards
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