Overview
Join our dynamic healthcare team, Contemporary Care LLC, as an Experienced Credentialing Manager, where your expertise will drive the efficient and compliant credentialing processes essential to delivering high-quality patient care. In this pivotal role, you will oversee the credentialing and provider enrollment functions, ensuring all healthcare providers meet regulatory standards and payer requirements. Your leadership will support our mission to maintain accreditation standards and uphold healthcare compliance across all operational facets. This position offers an exciting opportunity to influence healthcare quality and compliance while working in a fast-paced, collaborative environment.
Responsibilities
- Lead and manage the entire credentialing lifecycle for healthcare providers, including initial applications, re-credentialing, and ongoing verification processes.
- Oversee medical payer enrollment activities, ensuring timely and accurate submission of credentialing applications to insurance payers and government agencies such as Medicare
- Review medical credentialing applications thoroughly, verifying credentials against licensing boards, educational institutions, and professional references.
- Maintain comprehensive databases of provider information, ensuring data accuracy and confidentiality in accordance with healthcare compliance standards.
- Ensure adherence to federal, state, and local healthcare regulations
- Stay current with evolving health regulation policies, Medicare updates, and insurance industry changes to ensure ongoing compliance.
- Utilize healthcare software applications and Microsoft Office tools to streamline credentialing workflows and generate detailed reports for management review.
- Handle sensitive confidential information with integrity while maintaining strict compliance with privacy laws such as HIPAA.
Experience
- Proven experience managing medical credentialing processes within a managed care or healthcare organization.
- Strong administrative background within healthcare settings, demonstrating familiarity with medical office operations and healthcare software applications.
- Extensive knowledge of medical payer enrollment procedures and CMS regulatory compliance requirements.
- Hands-on experience reviewing medical credentialing applications in accordance with accreditation standards like NCQA and JCAHO.
- Database management experience with healthcare software systems used for credentialing tracking and provider data management.
- In-depth understanding of health insurance policies, state healthcare regulations, and healthcare compliance standards.
- Contract management experience in a healthcare environment is highly desirable.
- Excellent organizational skills paired with attention to detail necessary for managing complex credentialing workflows efficiently.
This role offers a rewarding opportunity to contribute meaningfully to healthcare quality assurance through meticulous credentialing practices. If you are driven by precision, compliance, and making a difference in patient care delivery, we invite you to apply!
Pay: $60,000.00 per year
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Work Location: In person
