USA Clinics Group
Healthcare
CredentialingManager
“Credentialing Manager at USA Clinics Group. Skills: Credentialing, Payer enrollment, Process improvement, Automation. Manage credentialing operations. Manage payer enrollment operations”
What You'll Achieve.
Ensure timely completion of provider applications; Ensure timely completion of provider renewals; Reduce delays; Improve efficiency
Industry & Context.
Resolve enrollment issues
What They're Looking For.
Must Have
5 years provider credentialing experience, 5 years payer enrollment experience, Knowledge of CAQH, Knowledge of Medicare, Knowledge of Medicaid, Knowledge of commercial payer enrollment, Knowledge of provider licensing requirements, Experience managing credentialing workflows, Experience managing productivity metrics, Experience managing provider onboarding timelines, Proficiency with credentialing software, Proficiency with reporting tools, Proficiency with document management systems
Nice to Have
Associate's degree in Healthcare Administration, Associate's degree in Business Administration, Associate's degree in related field, Bachelor's degree in Healthcare Administration, Bachelor's degree in Business Administration, Bachelor's degree in related field
What You'll Do.
Manage credentialing operations
Manage payer enrollment operations
Ensure timely provider applications
Ensure timely provider renewals
Monitor department productivity
Monitor application status
Monitor enrollment aging
Monitor onboarding timelines
Develop operational reports
Develop KPI tracking tools
Standardize credentialing processes
Identify opportunities to reduce delays
Identify opportunities to improve efficiency
Train credentialing staff
Mentor credentialing staff
Support credentialing staff
Ensure adherence to payer requirements
Ensure adherence to regulatory requirements
Coordinate escalations with payers
Coordinate escalations with providers
Coordinate escalations with internal stakeholders
Resolve enrollment issues
Lead process improvements
Execute department initiatives
Automate provider status updates
Automate enrollment tracking
Automate stakeholder communications
Implement automated alerts for expiring licenses
Implement automated alerts for expiring certifications
Implement automated alerts for expiring malpractice coverage
Implement automated alerts for payer renewals
Develop AI-assisted dashboards
Monitor application progress
Monitor team productivity
Utilize automation tools to reduce manual document collection
Utilize automation tools to reduce manual document tracking
Utilize automation tools to reduce manual document reporting
How You'll Work.
Team & Collaboration
Coordinate with payers; Coordinate with providers; Coordinate with internal stakeholders
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