HSCSN Mgr Cred Prov Data Mgmt - (260000UT)
Description
The Credentialing and Provider Data Manager is responsible for overseeing all aspects of provider credentialing, recredentialing and the integrity of provider data within the health plan. This includes ensuring compliance with federal and state regulations, accreditation standards (e.g., NCQA, CMS, DOH), and contractual obligations. The role provides leadership for credentialing and provider data management operations, including process development, data quality, delegated oversight, provider data management, provider directory management and audit readiness. The Manager will also serve as the point of contact for credentialing-related audits and ensure timely, accurate updates to provider directories and databases. The Manager supervises the Provider Data Specialist and Credentialing Coordinators.
Qualifications
Minimum Education
Bachelor's Degree (Preferred)
Minimum Work Experience
7 years Credentialing experience (Required) And
5 years Supervisory or management experience (Required)
Required Skills/Knowledge
Excellent written and verbal communication skills
Strong presentation skills
In-depth knowledge of health plan and medical staff credentialing practices
Strong familiarity with accreditation standards and regulatory frameworks (e.g., NCQA, JC, AAAHC, CMS, DHCF)
Proven ability to improve process efficiency and implement system automation
Experience with credentialing software and provider data systems
Ability to interpret documents, licenses, certifications, and accrediation standards
Ability to manage multiple priorities in a fast-paced environment
Required Licenses and Certifications
Certified Provider Credentialing Specialist (CPCS) 1 Year (Required)
Job Functions
Organizational Accountabilities
Organizational Accountabilities (Managers)
Leadership Excellence
Collaboration
Leadership Skills
Supervisory Responsibilities
Blood Borne Pathogen Exposure
Protected Health Information Access Level
Working Environment
Physical Requirements
Travel Requirements
Primary Location: District of Columbia-Washington
Work Locations: HSCSN - Vermont Ave 1101 Vermont Ave NW Washington 20005
Job: Management
Organization: HSC W/Special Needs
Position Status: R (Regular) - FT - Full-Time
Shift: Day
Work Schedule: 8:30am - 5:00pm
Job Posting: Apr 19, 2026, 4:11:48 PM
Full-Time Salary Range: 85404.8 - 142334.4
