Credentialing Manager

Job Summary

The Credentialing Manager will oversee offshore credentialing operations in Pakistan, ensuring U.S. provider credentialing and recredentialing activities comply with NCQA, CMS, and payer requirements, while managing team performance and audit readiness.

Key Responsibilities

• Lead end-to-end provider credentialing, recredentialing, and Primary Source Verification (PSV)
• Ensure compliance with NCQA standards and delegated credentialing guidelines
• Manage CAQH reviews, licenses, DEA, board certifications, sanctions, and work history checks
• Supervise, train, and evaluate offshore credentialing staff
• Coordinate with U.S. clients, payers, and providers across time zones
• Maintain audit-ready documentation and credentialing reports

Required Qualifications

• Bachelor’s degree or equivalent experience
• 4–6+ years of U.S. healthcare credentialing experience
• Strong knowledge of NCQA, CMS, Medicare/Medicaid, and commercial payers
• Excellent English communication and team-management skills

Job Type: Full-time

Pay: Rs100,000.00 - Rs300,000.00 per month

Work Location: In person