Credentialing Program Manager

Role Overview

• The Credentialing Program Manager reports to the Medical Affairs Manager.
• Direct, monitor and provide quality credentialing, re-credentialing and privileging processes.
• Conduct, participates in, and maintains primary source verification.
• Manage the credentialing, recredentialing and privileging process.
• Analyze application and supporting documents for completeness.
• Independently investigates and validates the information and escalates findings as needed.
• Prepare report for the Medical Executive Committee and Board of Trustees for final approval.

Requirements

• Bachelor's Degree (Required)
• Additional Job Description: Degree or three years of credentialing experience accepted in lieu of bachelor’s degree.
• In-depth understanding of provider credentialing, privileging and recredentialing processes including regulatory and accreditation standards.
• Proficiency in credentialing software and managing databases to track provider credentials and deadlines accurately.

Benefits

• Health insurance
• 401(k) matching
• Flexible work hours
• Paid time off
• Professional development opportunities