Credentialing Manager
4 days ago
At the Louisiana Primary Care Association, we are seeking a highly skilled Credentialing Manager to oversee the successful operations of our credentialing program. This is a full-time exempt position that reports to the Director of Managed Care and Network Development.
About UsThe Louisiana Primary Care Association promotes accessible, affordable, quality primary healthcare services for the uninsured and medically underserved populations in Louisiana. We are a membership organization of Federally Qualified Health Centers (FQHCs) and supporters committed to achieving healthcare access for all.
Job SummaryThe Credentialing Manager is responsible for ensuring the integrity of the credentialing data entered by our health centers, establishing and maintaining key support functions related to the program, and leading the development and implementation of approved policies and procedures for health plan delegated credentialing.
Responsibilities- Internal Credentialing:
- Configure the CredentialStream platform to support internal credentialing requirements.
- Review monthly releases to ensure system updates and enhancements support a stable environment.
- Ensure workflows and processes meet credentialing and privileging requirements.
- Assist providers with privileging and credentialing applications.
- Maintain licensed staff information and track license expirations.
- Work with the Chief Medical Officer to process applications for appointment and reappointment of privileges.
- Payor Enrollment and Credentialing:
- Lead the set-up of the payor enrollment module in CredentialStream.
- Develop and implement a strategy for obtaining and maintaining delegated credentialing agreements with payors.
- Ensure health centers maintain credentials with third-party payors.
- Prepare and maintain credentialing files and reports for individual providers.
- Bachelor's degree.
- At least five years of credentialing experience.
- Certified Provider Medical Services Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS) Certification preferred.
- Strong technical skills and database management skills.
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Credentialing Manager
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Baton Rouge, Louisiana, United States Louisiana Primary Care Association Full timeCredentialing Manager Job DescriptionAt the Louisiana Primary Care Association, we are seeking a highly skilled Credentialing Manager to oversee the successful operations of our credentialing program. This is a full-time exempt position that reports to the Director of Managed Care and Network Development.About UsThe Louisiana Primary Care Association...
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