Credentialing Manager

Role: Credentialing Manager

Location: Dallas, TX 75251

Duration: 3 Months Contract to Hire

OnsiteRequirements: This is a hybrid role with an expectation of onsite presence twice a week. Typical days onsite needed would be Mondays, Tuesdays or Wednesdays.

Job Description:

Client is seeking a Regional Credentialing Manager to join our team in Dallas, TX. Seeking candidates with minimum of 5 years’ experience as Credentialing Manager .This position oversees the credentialing operations of the CLIENT Dallas platform to develop, manage and monitor processes and procedures that support the credentialing & re-credentialing processes. Oversight of all credentialing functions including application management and primary source verification. Ensures compliance with the appropriate accrediting and regulatory agencies.

Essential Duties And Responsibilities (include but not limited to):

• At a regional level, supervises direct and indirect staff members with performance and talent management.
• Leads credentialing team with coaching and feedback of employee work performance, work behaviors to develop skills and monitor team workflows.
• Collaborate with operations team to create credentialing standards and procedures and execute the implementation and monitoring of standards and procedures within assigned region.
• Monitor credentialing departments for possible clinical and financial risks as it pertains to provider credentialing and onboarding.
• Administers teams to be accountable for quality and production standards and monitors progress with established goals and metrics.
• Oversees the onboarding of new groups and facilities.
• Works with leadership teams to ensure compliance with (NCQA and CMS standards and guidelines; identifies and monitors The Joint Commission, URAC, AAAHC accreditation standards, and policies, and other federal and state legislation, as appropriate)
• Partners with organizational key stakeholders to support and prepare for regulatory, NCQA, CMS, and client health plan audits.
• Establish and foster strong working relationships with billing departments to improve processes and communication between the enrollment and billing departments.
• Maintain department budgets at or below the yearly projections.
• Models collegial environment, which fosters teamwork for local teams, with other members of the clinical services, operations and field providers.
• Provides regular reports and updates to RCM and national leadership, as applicable.
• Work with local leadership to plan and prepare for future growth and needs of local offices.

About AgreeYa: 
AgreeYa is a global systems integrator delivering a competitive advantage for its customers through software, solutions, and services. Established in 1999, AgreeYa is headquartered in Folsom, California, with a global footprint and a team of more than 1,800 professionals across offices. AgreeYa works with 550 organizations ranging from Fortune 100 firms to small and large businesses across industries such as Telecom, Banking, Financial Services & Insurance, Healthcare, Utility & Energy, Technology, Public Sector, Pharma & Biotech, Retail, CPG, and others.