Credentialing Manager

About Advantmed:

At Advantmed our mission is to improve the healthcare system by ensuring appropriate, quality care, and eliminating unnecessary costs. Advantmed is a leading provider of risk adjustment, quality improvement and value-based solutions to health plans and providers. We drive market leading performance with integrated technology, service, and program solutions that optimize the risk and quality performance of our partners. Our solutions focus on identifying, managing, and documenting risk and quality performance, and the proactive clinical engagement of high acuity populations.

Primary Purpose:

We are seeking a highly skilled and experienced Credentialing Manager to oversee our credentialing process and ensure that our organization complies with all relevant regulations and guidelines. The ideal candidate will have NCQA certification experience and a proven track record of success in managing a credentialing...

Life at aptihealth

Backed by $70M in funding from world-class investors including Takeda Digital Ventures, Pivotal Life Sciences and Vista, the aptihealth team is comprised of health care, data science and technology experts passionate about transforming behavioral healthcare. aptihealth is a digital technology platform with an affiliated medical group that makes it easier for people to access speedy high quality mental health care at the right place and right time.   The technology and provider group reach people who need care, connect, follow and demonstrate improved outcomes. Everything we do at aptihealth is centered on our mission to revolutionize care and to ensure that the millions of people who need and deserve it have access to it. As a curious and collaborative teammate, someone excited about tackling the hard problems in healthcare and technology, you will play a key role in making that mission a reality. Together, we’ll create and...

About the Role:  

The Credentialing Manager is responsible for the day-to-day management of the Credentialing and Compliance department. The Credentialing Manager will bring excellent analytical, organizational, time management, people management, and project management skills to the department, and will support the Compliance Manager with projects and priorities. The Credentialing Manager will handle escalated issues and will monitor and coach the team to meet strict timelines with a high level of accuracy. The Credentialing Manager will have a clear understanding of individual and delegated credentialing processes as well as compliance requirements. 

Work Environment: 

• The position is a hybrid position based at Mindful Support Services’ Mountlake Terrace, WA Headquarters. 
• Initial and subsequent training will be conducted in-office before switching to a hybrid schedule, so only local candidates...

About the Role:  

The Credentialing Manager is responsible for the day-to-day management of the Credentialing and Compliance department. The Credentialing Manager will bring excellent analytical, organizational, time management, people management, and project management skills to the department, and will support the Compliance Manager with projects and priorities. The Credentialing Manager will handle escalated issues and will monitor and coach the team to meet strict timelines with a high level of accuracy. The Credentialing Manager will have a clear understanding of individual and delegated credentialing processes as well as compliance requirements. 

Work Environment: 

• The position is a hybrid position based at Mindful Support Services’ Mountlake Terrace, WA Headquarters. 
• Initial and subsequent training will be conducted in-office before switching to a hybrid schedule, so only local candidates...

About the Role:  

The Credentialing Manager is responsible for the day-to-day management of the Credentialing and Compliance department. The Credentialing Manager will bring excellent analytical, organizational, time management, people management, and project management skills to the department, and will support the Compliance Manager with projects and priorities. The Credentialing Manager will handle escalated issues and will monitor and coach the team to meet strict timelines with a high level of accuracy. The Credentialing Manager will have a clear understanding of individual and delegated credentialing processes as well as compliance requirements. 

Work Environment: 

• The position is a hybrid position based at Mindful Support Services’ Headquarters. 
• Initial and subsequent training will be conducted in-office before switching to a hybrid schedule, so only local candidates will be...

MAJOR FUNCTION

The Credentialing Manager is responsible for overseeing all aspects of credentialing applications and renewals for health care professionals. This position develops, implements, and monitors policies and procedures that support credentialing, re-credentialing, data management and delegated credentialing contract processes. The Credentialing Manager manages all credentialing functions including application management and primary source verification, ensures compliance with appropriate accrediting and regulatory agencies, supervises credentialing staff, and oversees credentialing workflows and/or services provided by third party vendors as appropriate. The Credentialing Manager will conduct all aspects of third-party credentialing for providers and facilities in accordance with CMS, FQHC (Federally Qualified Health Center) and third-party insurance standards.

ESSENTIAL FUNCTIONS

• Manages...