Credentialing Manager

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 will be considered.
• This role requires prolonged periods of sitting at a desk and working on a computer. 

Responsibilities:  

• Oversee all aspects of provider insurance credentialing (individual credentialing applications and delegated credentialing) 
• Provide daily direction and priorities to Credentialing Specialists 
• Develop, monitor, coach, and manage staff ensuring the development of employees through training, setting clear expectations, providing constructive feedback, and completing regular performance evaluations 
• Identify and resolve credentialing issues through regular auditing and reporting 
• Maintain detailed knowledge of current government and third-party payor-specific regulations and ensure the organization is compliant with these requirements 
• Actively identify, initiate, drive and participate in quality improvement initiatives in accordance with the organization's mission and strategic goals, federal and state laws and regulations, and delegated credentialing standards 
• Create, maintain and update department resources  
• Collaborate with other departments to research and resolve credentialing or compliance escalations. 
• Lead major projects within the Credentialing & Compliance Department 

Requirements

Qualifications: 

• 3+ years of multi-state provider credentialing experience  

• 2+ years of leadership experience 
• Strong project management skills 
• Extensive knowledge of state and federal healthcare legislation, credentialing and contracting protocol, and NCQA (National Committee on Quality Assurance) requirements 
• Certified Provider Credentialing Specialist (CPCS) certification preferred  
• Prior experience and success in a fast-growing organization preferred 

Core Competencies:  

• Strong sense of urgency to resolve escalated issues and concerns  
• Strong verbal and written communication 
• Demonstrated critical thinking and problem-solving skills 
• Strong organization and time management skills 
• Ability to work effectively both independently and as a team 
• Proficient with Microsoft Office Suite, particularly Excel and SharePoint 

Benefits

Compensation and Benefits:

• 75% employer covered Health, Dental & Vision benefits plan
• 401(k) savings plan with employer matching upon eligibility
• 8 paid holidays
• 15 PTO days accrued annually
• Professional and career development opportunities
• Compensation evaluated with opportunities for advancement

Job Type: Full-time

Salary: $75,000-$90,000