Credentialing Manager

Behavior Frontiers; El Segundo (CA); Hybrid; USD 75,000 - 85,000; Full time

Benefits offered by this job

401K Plan with company match

Paid Personal Time Off

Free Telehealth services

Fitness discounts

Employee Assistance Program

Job summary

Behavior Frontiers is seeking an experienced Credentialing Manager to oversee and manage the credentialing process. In this role, you will supervise daily operations, ensuring accuracy in the credentialing database while maintaining strong relationships with funding sources.

With a competitive salary range of $75,000 - $85,000 and extensive benefits including health insurance and paid time off, this position offers an excellent opportunity for career advancement in a growing field within healthcare.

Qualifications

• 3-5 years credentialing experience in the behavior health or related industry.
• Ability to effectively represent Behavior Frontiers to external partners.
• Excellent verbal and written communication skills.

Responsibilities

• Supervise/manage credentialing and recredentialing process.
• Create and maintain provider files.
• Report updates to funding sources and internal departments.

Skills

Credentialing experience

Knowledge of NCQA guidelines

Relationship development

Organizational abilities

Problem solving

Communication skills

Education

Bachelor's degree

Job description

Overview

Description Behavior Frontiers is an industry leader in ABA (Applied Behavior Analysis) treatment for autism and other special needs. We are on a continuous journey to explore, assess, and develop only the highest quality ABA treatments and solutions delivered by best-in-class clinical professionals. We are rapidly expanding and seeking enthusiastic individuals who are ready to embark on a meaningful journey in one of the fastest growing fields in healthcare. Our Credentialing Manager position plays a critical role in our company, and we need an individual with great interpersonal skills, detail oriented, is great at multi-tasking and time management.

Hours: Full Time (Monday – Friday/40hrs a week)

Office Location: El Segundo, CA Headquarters (Hybrid)

Compensation: $75,000 - $85,000 DOE

Responsibilities

• Supervise/manage the day-to-day operational functions of credentialing and recredentialing process and personnel to include workflow management, troubleshooting, log management, process updates, reporting and training.
• Create and maintain individual provider files including credentialing status and supporting documentation.
• Track and ensure accuracy of new/promoted provider credentialing and/or application status in database, and make updates for existing providers.
• Act as a resource for other managers and coworkers and respond to internal and external requests for credentialing information and documentation.
• Work closely and transparently with internal departments and external partners.
• Regularly report updated provider and location rosters to funding sources and internal departments.
• Support contract development goals to include researching new funding sources, unique contracting process requirements, data gathering, forms completion, submissions, tracking, follow up and reporting.
• Keep abreast of relevant legal, regulatory, and legislative changes related to credentialing, contracting and licensing.
• Maintain comprehensive working knowledge of contractual relationships including credentialing and contracting requirements by funding source.
• Develop and maintain positive and cooperative relationships with funding source representatives and coworkers.
• Contribute to the on-going development of new funding sources.
• Complete special projects as assigned.
• Maintain confidentiality in matters of company operations, personnel, and clients.
• Perform other duties, as assigned.

Qualifications

• 3-5 years credentialing experience in the Behavior Health or related industry
• Knowledge of NCQA credentialing guidelines
• Experience developing and maintaining relationships with a variety of funding sources
• Must be self-directed, exercise initiative, discretion and seek guidance as appropriate
• Superior organizational and multi-tasking abilities with high attention to detail
• Ability to make sound decisions, prioritize effectively and problem solve
• Ability to effectively and professionally represent BF to funding sources and external partners
• Ability to work independently in a fast-paced environment, flexible and adaptable
• Excellent verbal and written communication skills
• Bachelor’s degree required
• Provide negative TB test results
• Ability to clear FBI & DOJ fingerprinting

Why Behavior Frontiers is perfect for you

• Competitive pay with optional On-demand paychecks thru DailyPay - get paid on your own schedule!
• 401K Plan with company match after 6 months of employment
• Paid Personal Time Off
• Paid Holidays
• Paid Sick Leave
• Medical, Dental and Vision insurance
• Opportunities for career advancement
• Performance and promotion raise
• Paid Maternity Leave - Up to 9 Weeks
• Free Telehealth: Free 24/7 access to a doctor via telehealth for you and your dependents with no limits and no co-pays
• Free Telehealth Mental Health: Free access to a mental health counselor via telehealth for you and your dependents (over age 13) with no limits or co-pays
• Employee Assistance Program: Free access to some support services (financial, legal, counseling, etc.)
• Fitness: Discounted monthly gym membership to 12,000 gym locations nationwide, as well as free access to workout videos
• Deals: Exclusive discounts and savings to 500+ companies and more!
• Travel: Discounts on travel essentials including hotels, rental cars, flights, excursions, and more!
• Lab Testing Discounts: 10-80% off costs of routine lab work
• New Benefits Rx: Discounts on prescription medications from 10-80% at 60,000+ locations nationwide

Why work for Behavior Frontiers? Visit our benefits & perks page to learn more!

Behavior Frontiers is an Equal Opportunity Employer and will consider for employment all qualified applicants in a manner consistent with the requirements of the applicable federal, state, and local laws.