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Putting members first since 1933.
Credentialing Manager
Location
South Carolina
Posted
93 days ago
Salary
$90.1K - $157.6K / year
Seniority
Senior
Job Description
Credentialing Manager
PacificSource Health Plans
• Manage all provider credentialing, recredentialing, and document and related data management processes • Collaborate with provider partners, internal customers, and other external constituents • Supervise and provide guidance to assigned staff • Participate in hiring process • Train and evaluate team member performance • Develop annual budgets and monitor spending • Proactively work with other departments to improve interdepartmental processes • Employ lean methodologies for continuous improvement • Maintain and negotiate delegated credentialing agreements
Job Requirements
- Minimum of five years health insurance experience
- At least three years credentialing experience
- Three years of experience managing teams in a health care environment
- Bachelor's degree preferred
- Knowledge of healthcare delivery, NCQA and HIPAA are essential
- Attention to detail; ability to handle multiple tasks and prioritize effectively
- Must show initiative in approaching projects and day-to-day work
- Proficient in Word, Excel, Databases and credentialing software programs
Benefits
- Flexible telecommute policy
- Medical, vision, and dental insurance
- Incentive program
- Paid time off and holidays
- 401(k) plan
- Volunteer opportunities
- Tuition reimbursement and training
- Life insurance
- Options such as a flexible spending account
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