Credentialing Senior Manager

2 weeks ago


San Antonio, Texas, United States University Health Full time

Job Summary

University Health seeks a highly skilled Credentialing Senior Manager to oversee the credentialing and recredentialing program of practitioners and providers. The successful candidate will ensure compliance with regulatory and accreditation standards, monitor industry developments, and implement policy and procedural changes as needed.

Key Responsibilities

  • Implement and oversee the credentialing and recredentialing program, including entities delegated for credentialing
  • Monitor regulatory, contractual, and accreditation standards and implement policy and procedural changes
  • Collaborate with consortium health plans to review and coordinate contractual requirements for the verification process
  • Coordinate research and Credentialing Committee reports of initial practitioners with issues and reports from licensing and monitoring organizations
  • Coordinate with the Chief Medical Officer or designee for administration of the Credentialing Committee and Committee actions

Requirements

  • An associate degree in a health care-related or business management field or five years of equivalent experience
  • Excellent written and oral communication, problem-solving, organizational skills, statistical, and analytical abilities
  • Knowledge of accreditation credentialing standards (such as NCQA), federal, state, and regulatory agency requirements
  • At least five years of supervisory experience in a managed care setting with exposure to multiple product lines and communication with regulatory agencies
  • NAMSS Certification as Certified Provider Credentials Specialist (CPCS) is preferred

Why Join Our Team

As a Credentialing Senior Manager at University Health, you will have the opportunity to work with a talented team of professionals dedicated to delivering high-quality healthcare services. We offer a dynamic and supportive work environment, competitive compensation, and opportunities for professional growth and development.



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