Healthcare Credentialing Manager

1 month ago


Morgantown, West Virginia, United States Peak Health Full time
Job Summary

We are seeking a highly skilled and experienced Credentialing and Provider Data Management Manager to join our team at Peak Health. As a key member of our Provider Relations leadership team, you will be responsible for overseeing all aspects of our credentialing and provider data management process.

Key Responsibilities
  • Plan, organize, and direct the day-to-day operations of credentialing and provider data management.
  • Supervise and manage a team of credentialing and provider data management staff.
  • Develop and implement standards and procedures for credentialing and provider data management in compliance with regulatory and accreditation requirements.
  • Prepare and present key operational reports to internal and external stakeholders.
  • Maintain comprehensive knowledge of state and federal statutory requirements and ensure compliance with all legal, licensure, and accreditation standards.
  • Collaborate with internal and external stakeholders to achieve goals and objectives.
Requirements
  • Bachelor's degree in Business Administration, Healthcare Administration, or related field.
  • Five years of experience in credentialing, preferably in a managed care setting.
  • One year of supervisor experience.
  • Completion of NAMSS Certified Provider Credentialing Specialist exam within 18 months of hire.
Preferred Qualifications
  • Master's degree in Healthcare Administration, Business Administration, or related field.
  • Seven years of professional experience in credentialing, with two years of employee/team management experience.
  • Experience utilizing HealthStream's (VerityStream) CredentialStream credentialing software application platform.
  • NAMSS Credentialing Certification within 18 months of employment.
Work Environment

This is a hybrid role, with a mix of remote and on-site work. The successful candidate will be required to work in a fast-paced and dynamic environment, with a focus on delivering high-quality results and meeting deadlines.

What We Offer

Peak Health offers a competitive salary and benefits package, as well as opportunities for professional growth and development. We are an equal opportunity employer and welcome applications from diverse candidates.



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