Healthcare Credentialing Manager

1 day ago


Philadelphia, Pennsylvania, United States Jefferson Health Full time
Job Title: Central Enrollments Department Manager

Jefferson Health seeks an experienced professional to lead the Central Enrollments department, responsible for the operations of health plan enrollment and physician credentialing. This role requires strong leadership and management skills, as well as expertise in healthcare credentialing and billing.

Key Responsibilities:
  • Manage the delegated credentialing process, ensuring compliance with contractual obligations and external regulations.
  • Oversight of the primary source verification process for credentialing providers.
  • Develop and implement departmental standards and procedures for data integrity, confidentiality, and storage.
  • Coordinate with internal departments, including Medical Staff Affairs Office, JeffCARE, and JMC Faculty Affairs.
  • Review and negotiate delegated health plan contract language, ensuring compliance with external and internal policies.
  • Oversee the delegated provider enrollment process, including credentialing staff and ensuring timely completion of health plan applications.
Qualifications:
  • High School Diploma, Associate or Bachelor Degree Preferred
  • Minimum 2 years of healthcare credentialing/billing experience
  • Minimum 3 years customer service and managed care contract experience
  • Certified Provider Credentialing Specialist (CPCS)
  • Minimum 2 years supervisory experience in a position involving physician enrollment/credentialing and billing
About Jefferson Health:

Nationally ranked, Jefferson Health is a leading healthcare and higher education institution, committed to providing the highest-quality clinical care, making our communities healthier and stronger, and creating new knowledge through research.

Conditions of Employment:

Covid Vaccination is a requirement for employment at Jefferson Health for employees working at Jefferson's clinical entities.



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