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Credentialing Program Manager
2 months ago
Louisiana Primary Care Association is seeking a highly organized and detail-oriented Credentialing Program Manager to oversee the successful operations of our credentialing program for the Louisiana Primary Care Accountable Care Organization (LPCACO).
The ideal candidate will have a strong understanding of healthcare credentialing processes, experience with credentialing software, and excellent communication and interpersonal skills.
About UsThe Louisiana Primary Care Association (LPCA) is dedicated to promoting 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.
Position SummaryThe Credentialing Program Manager will be responsible for ensuring that our credentialing program meets the needs of our member health centers, as well as the requirements of various payors. This includes overseeing the implementation and maintenance of our credentialing software, providing training and support to health center staff, and managing the credentialing process for all providers.
Responsibilities- Develop and implement policies and procedures for the credentialing program.
- Oversee the implementation and maintenance of our credentialing software.
- Provide training and support to health center staff on the credentialing process.
- Manage the credentialing process for all providers, including primary care physicians, specialists, and allied health professionals.
- Maintain accurate records of provider credentials and insurance information.
- Respond to inquiries from payors regarding provider credentials.
- Stay up-to-date on changes in credentialing regulations and requirements.
- Bachelor's degree required.
- At least five years of experience in healthcare credentialing, preferably in an FQHC setting.
- Certified Provider Medical Services Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS) Certification preferred.
- Strong technical skills and database management skills. Experience with CredentialStream or other web-based credentialing software is a plus.
- Working knowledge of applicable accreditation and regulatory standards (e.g., NCQA, URAC).
