Credentialing Supervisor

This is a fully remote position, open to applicants in United States.

📋 Description

• Lead the team responsible for provider credentialing and enrollment, setting priorities, tracking performance, and encouraging professional growth.

• Supervise provider onboarding processes related to credentialing, payer enrollment, and preparation for clinical practice.

• Ensure the prompt completion of initial credentialing, recredentialing, and payer enrollment across all contracted health plans.

• Manage provider maintenance tasks, including demographic updates, monitoring of licensure, CAQH maintenance, payer roster updates, and revalidation.

• Create and refine credentialing workflows, policies, and standard operating procedures.

• Collaborate with Clinical Operations, Human Resources, Compliance, and Revenue Cycle departments.

• Address complex credentialing and enrollment issues with payers, delegated credentialing organizations, and regulatory bodies.

• Track credentialing metrics, turnaround times, and key performance indicators.

• Keep accurate credentialing records and documentation across credentialing systems and payer portals.

• Coordinate credentialing for new locations, payer contracts, and acquisitions.

• Establish and nurture relationships with payer representatives and external credentialing partners.

⛳️ Requirements

• Outstanding organizational abilities, keen attention to detail, and a strong dedication to accuracy.

• Capacity to autonomously lead and manage credentialing operations with accountability.

• Excellent prioritization and workload management capabilities.

• At least 3 years of experience in provider credentialing, recredentialing, and payer enrollment.

• A minimum of 2 years of leadership or supervisory experience is preferred.

• Proven experience in managing multi-state credentialing and recredentialing operations.

• Advanced computer skills, including proficiency in Microsoft Office Suite and credentialing, payer, or provider database systems.

• Familiarity with credentialing software, oversight of data integrity, report generation, and process enhancement.

• Strong verbal and written communication abilities.

• Understanding of confidentiality requirements and capacity to handle sensitive information with discretion.

• Skill in developing, monitoring, and enhancing credentialing processes, policies, and performance metrics.

• Knowledge of NCQA, CMS, Medicaid, commercial payer, and accreditation-related credentialing standards.

• A Bachelor's degree in healthcare administration, Business Administration, Health Information Management, or a related field is preferred.

🏝️ Benefits

• Competitive salary and performance-based incentives.

• Comprehensive health, dental, and vision insurance.

• Opportunities for professional development and continuing education.

• Flexible work schedule and remote work options.

• Generous paid time off and holidays.