Medical Staff Credentialing Manager manages staff that process credentialing and recredentialing applications for health care providers. Oversees department operations to ensure compliance with all regulatory standards. Being a Medical Staff Credentialing Manager implements policies and procedures to ensure that applications are properly verified and accurately uploaded into an online credentialing database system. Analyzes reports on applications and credentialing status to identify trends and improve the credentialing process. Additionally, Medical Staff Credentialing Manager prepares files for the credentialing committee and may act as a liaison to state medical licensure boards regarding the status of license applications. Requires a bachelor's degree. May require Certified Provider Credentialing Specialist (CPCS). Typically reports to a director. The Medical Staff Credentialing Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. To be a Medical Staff Credentialing Manager typically requires 5 years experience in the related area as an individual contributor. 1 - 3 years supervisory experience may be required. Extensive knowledge of the function and department processes. (Copyright 2024 Salary.com)
Summary:
The Provider Credentialing and Enrollment Manager is responsible for managing and supporting the administrative and operational aspects of all provider and payer credentialing and enrollment.
This position serves as a subject matter expert by providing guidance and problem/issue resolution to internal colleagues on matters impacting projects and day-to-day activity. Strong relationship, communication, analytical and evaluative skills, and the ability to contribute to and provide primary accountability for managing/leading small projects or portions of projects is expected. Assignments may require interfacing with gathering information from and making presentations to various levels of management and internal or external executive leaders.
Essential Duties and Responsibilities:
Skills Required:
Background Checks are required for this role.
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