Outpatient Provider Credentialing Manager

Job description

Quali fications: Education, Licensure and Certifications, Related Work Experience · Associate’s degree or equivalent required. Bachelor's degree preferred · Minimum 5 years of provider credentialing experience in outpatient or multi-specialty settings · CPCS or CMSC highly desirable Other specialized skills and knowledge necessary to perform this job. (e.g., basic accounting principles, computer skills and software, specific healthcare processes, interpersonal, communication, etc. 1. Proficiency with credentialing software (MedTrainer, Modio, or similar) 3. Credentialing regulations (CMS, NCQA, Joint Commission) and Payer enrollment, CAQH, PECOS, knowledge 2. Strong analytical and organizational skills: 4. Ability to manage competing priorities and deadlines Essential Job Duties/Responsibilities: 1. Oversee end-to-end credentialing and recredentialing for all outpatient providers 2. Manage credentialing staff and external vendors; provide training and performance management 3. Ensure compliance with CMS, NCQA, Joint Commission, and payer standards 4. Maintain and optimize credentialing databases and tracking systems 5. Oversee payer enrollment, monitor rosters, resolve discrepancie...