Description

The Credentialing Manager position requires an organized individual with good time management skills, previous management as well as medical provider credentialing and privileging experience. The Credentialing Manager is responsible for ensuring that all credentialing and privileging responsibilities are completed accurately and on time.

Summary Of Duties

Primary duties include but are not limited to the following:

80% of the time: Department Management

• Receives client requests for provider credentialing and privileging and distributes assignments to maintain efficient staff productivity
• Maintains department training program and performs new employe training
• Audits credentialing and privileging tasks and work product to maintain compliance with NCQA standards
• Weekly updates to VP of department metrics
• Communications with staff, vendors, client representatives and providers to address issues and provide updates per department policy.
  
  

10% of the time: Perform Enrollment, Credentialing + Privileging tasks

• Performs enrollment and provider credentialing and/or privileging as necessary to ensure timely completion of assigned work
  
  

10% of the time: Reporting

• Weekly updates to VP of department
• Updates to clients as directed by VP
• Reporting to other internal departments as directed
  
  

Requirements

Education and Training:

• High school diploma or equivalent (Required)
• Bachelor's degree in health care administration, finance, business, or related field (Preferred)
  
  

Knowledge And Experience

• Four (4) years' previous experience performing and/or managing a medical provider credentialing department or in a related healthcare administrative position
• Prior experience in managing or supervising delegated credentialing or auditing credentialing performance in compliance with NCQA standards highly preferred
  
  

Skills And Abilities

• Able to multitask, prioritize, and manage time efficiently
• Self-motivated and self-directed; able to work without supervision
• Excellent verbal and written communication skills
• Proficient computer skills, Microsoft Office Suite (Word, PowerPoint, Outlook, and Excel); working knowledge of billing software a plus
• Strong customer service skills and comfortable answering client and provider questions
• Able to analyze problems and strategize for better solutions
  
  

Work Location: In person

Pay: DOE; with semi-monthly pay schedule.

Job Type: Full-time

Full Time Benefits

• 401(k) + Financial Advisors
• Life + AD&D insurance
• Medical, Vision, Dental insurance
• Short- and Long-term Disability insurance
• Employee assistance program (EAP)
• Flexible schedule
• Health savings account (HSA)
• Paid Sick Leave
• Paid Vacation Leave
• Paid Holiday Leave
  
  

Schedule

• Day shift
• Monday to Friday
  
  

Ability To Commute/relocate

• Tucson, AZ 85716: Reliably commute or planning to relocate before starting work (Required)