Credentialing Manager (Remote)

1. Manages the credentialing process for all clinical providers, in accordance with, private insurance, Federal and State laws, and Medicaid policies.
2. Coordinates the management the credentialing database and associated modules, ensuring accuracy of data and reporting to downstream systems. Monitors critical data for extensive analysis and report generation.
3. Coordinates the management of the electronic credentials application, to ensure distribution, receipt, processing, and timely delivery to health system entity.
4. Coordinates the management of the expirables process to ensure all clinical provider licenses and certificates remain current, ensuring appropriate notification prior to expiration.
5. Monitors and reports turnaround times for processing of credentials applications, with continued focus on delivery of a high-quality product, with the greatest efficiency, in the least amount of time,
6. Monitors dept. entity-specific provider bylaws, rules and regulations, and policies and procedures, ensuring compliance with organization requirements; participates in development and review, Credentialing policies and procedures; develops, recommends, and/or implements changes, revisions, and enhancements as appropriate to current operating environment.
7. Prepares for and coordinates credentialing audits in compliance with the managed care delegated credentialing contracts.
8. Develops and maintains positive working relationships with staff and funding source contacts.
9. Oversees the supervision of personnel, which includes work allocation, training, promotion, enforcement of internal procedures and controls, and problem resolution; evaluates performance and makes recommendations for personnel actions; motivates employees to achieve peak productivity and performance.
10. Performs miscellaneous job-related duties as assigned.