Senior Manager, Credentialing

Job Summary

A company is looking for a Senior Manager, Credentialing & Enrollment.

Key Responsibilities

• Oversee operations of the Credentialing department, managing provider licensure, Medicaid enrollment, and health plan credentialing
• Supervise staff in processing applications, ensuring compliance with regulatory agencies and managing the Credentialing Program
• Facilitate Credentialing Committee meetings and act as a liaison with state licensure boards and health plan credentialing teams

Required Qualifications

• At least seven years of experience as a Credentialing Specialist
• A minimum of five years of experience managing a team of at least three members
• Previous experience with Credentialing functions in Verifiable and Athena
• CPCS or CPMSM certification highly preferred or actively pursuing certification
• Strong knowledge of licensure and Medicaid guidelines across multiple markets