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We identify, engage, and serve populations with behavioral health, medical, and social challenges across the continuum.
Credentialing Manager
Location
United States
Posted
115 days ago
Salary
$65K - $80K / year
Seniority
Senior
Job Description
Credentialing Manager
Mindoula
• The Credentialing Manager leads the end to end credentialing, privileging, and payer enrollment function for the Managed Service Organization. • Ensure timely, compliant provider onboarding while maintaining high standards of operational accuracy, audit readiness, and service excellence. • Oversee full lifecycle credentialing, re-credentialing, privileging, and payer enrollment for all providers. • Manage complex, escalated, or high priority credentialing cases. • Support compliance and audit readiness practices, maintaining audit ready provider files and documentation standards. • Provide day to day leadership, coaching, and workload management for credentialing specialists. • Develop team capabilities through training and process documentation. • Monitor turnaround times, application status, and enrollment effective dates. • Partner with cross-functional teams for seamless provider onboarding and resolve credentialing related denials or reimbursement delays.
Job Requirements
- Bachelor’s degree preferred; relevant experience may substitute
- CPCS certification strongly preferred
- Minimum three years of credentialing experience including payer enrollment and privileging
- Prior supervisory or team lead experience required
- Strong knowledge of NCQA, CMS, and payer credentialing standards
- Proficiency with Google Suite, Excel or Sheets, credentialing databases, and workflow tools
- Exceptional organizational skills and attention to detail
- Ability to manage multiple deadlines in a high volume environment
- Strong judgment, problem solving ability, and professional communication skills
- Ability to lead with accountability while maintaining strong provider relationships.
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