Full-Time Manager, Provider Credentialing

• Assures compliance with all health plan requirements.
• Manages and monitors activities of the department to ensure compliance with all policies/procedures and regulations
• Maintains a strong knowledge of the credentialing database.
• Provides administrative and operational backup/support to coordinators and the director.
• Comprehensive knowledge of NCQA standards.
• Reviews and streamlines processes and workflows, using automation.
• Works with technical staff to develop tools and procedures for auditing and reporting.
• Oversees special projects requiring knowledge of health plan requirements
• Manages day to day activity of Credentialing Specialists
• Interacts with varied levels of management, physician office staff and physicians effectively.
• Maintain up-to-date data for each provider in credentialing databases.
• Coordinate and prepare reports
• Record and track credentialing statistics
• Perform other duties as assigned

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