Credentialing Manager

Job Overview
We are seeking a dynamic and detail-oriented Credentialing Manager to lead our credentialing operations, ensuring that healthcare providers meet all necessary licensing, certification, and accreditation standards. In this pivotal role, you will oversee the credentialing process from start to finish, maintain compliance with industry regulations, and collaborate with internal teams to streamline provider onboarding. Your expertise will help uphold the highest standards of quality and compliance within our organization, supporting our mission to deliver exceptional healthcare services.

Responsibilities

• Manage the entire credentialing lifecycle for healthcare providers, including initial verification, re-credentialing, and ongoing monitoring.
• Ensure compliance with Managed Care contracts, NCQA (National Committee for Quality Assurance) standards, and other regulatory requirements.
• Collaborate with medical offices and internal departments to gather necessary documentation and verify provider credentials accurately.
• Maintain detailed records of credentialing activities, renewals, and audits to support accreditation processes.
• Review provider applications for completeness and accuracy, identifying any discrepancies or issues that need resolution.
• Stay current on industry regulations, updates in medical terminology, and best practices in credentialing processes.
• Lead efforts to improve efficiency in credentialing workflows through process enhancements and technology utilization.

Qualifications

• Proven experience in managed care or healthcare credentialing environments.
• Strong understanding of medical office operations and medical terminology.
• Familiarity with NCQA standards and accreditation requirements is highly desirable.
• Excellent organizational skills with keen attention to detail and accuracy.
• Ability to work independently while collaborating effectively with cross-functional teams.
• Prior experience with credentialing software or health information management systems is a plus. Join us in a role that is vital to maintaining the integrity of our healthcare network! We value energetic professionals who are committed to excellence, compliance, and continuous improvement in healthcare credentialing practices.

Job Type: Full-time

Pay: Rs120,000.00 - Rs175,000.00 per month

Work Location: Remote