Credentialing Manager

USA Clinics Group; Northbrook (IL); In loco; USD 75.000 - 95.000; Tempo pieno

Vantaggi offerti da questo lavoro

Health

Dental

Vision

401k & Match

Paid time off

Descrizione del lavoro

USA Clinics Group is seeking a Credentialing Manager in Northbrook, IL to oversee credentialing and enrollment activities while optimizing workflows. You will ensure timely provider onboarding while managing a dedicated team.

The role demands at least 5 years of experience in credentialing and payer enrollment, as well as proficiency with credentialing software. Key benefits include health, dental, and a 401k match.

Competenze

• Minimum of 5 years of experience in provider credentialing and payer enrollment.
• Strong knowledge of provider licensing requirements.
• Experience with productivity metrics and onboarding timelines.

Mansioni

• Manage day-to-day credentialing operations ensuring timely completion.
• Monitor department productivity and application statuses.
• Develop operational reports and KPI tracking tools.
• Train and support credentialing staff.
• Coordinate escalations with payers and providers.

Conoscenze

Knowledge of CAQH

Medicare and Medicaid enrollment

Proficiency with credentialing software

Managing credentialing workflows

Formazione

Associate's or Bachelor's degree in Healthcare Administration

Strumenti

Credentialing software

Reporting tools

Descrizione del lavoro

Position Summary:

The Credentialing Manager serves as the operational partner to credentialing leadership by managing day-to-day credentialing and enrollment activities, team performance, and workflow optimization. This role focuses on improving efficiency, implementing automation, and ensuring timely provider onboarding and compliance.

Position Details:

• Location: Northbrook, IL
• Schedule: Full-time, Monday through Friday on-site.
• Compensation: $75,000 - $95,000

Key Responsibilities

• Manage day-to-day credentialing and payer enrollment operations, ensuring timely completion of provider applications and renewals.
• Monitor department productivity, application status, enrollment aging, and onboarding timelines.
• Develop and maintain operational reports, dashboards, and KPI tracking tools.
• Standardize credentialing processes, maintain SOPs, and identify opportunities to reduce delays and improve efficiency.
• Train, mentor, and support credentialing staff while ensuring adherence to payer and regulatory requirements.
• Coordinate escalations with payers, providers, and internal stakeholders to resolve enrollment issues.
• Serve as the operational partner to the Director by leading process improvements and executing department initiatives.

AI & Automation Responsibilities

• Automate provider status updates, enrollment tracking, and stakeholder communications.
• Implement automated alerts for expiring licenses, certifications, malpractice coverage, and payer renewals.
• Develop AI-assisted dashboards that monitor application progress, aging, and team productivity.
• Utilize automation tools to reduce manual document collection, tracking, and reporting activities.

Minimum Requirements

• Associate’s or Bachelor’s degree in Healthcare Administration, Business Administration, or related field preferred.
• Minimum 5 years of provider credentialing and payer enrollment experience.
• Strong knowledge of CAQH, Medicare, Medicaid, commercial payer enrollment, and provider licensing requirements.
• Experience managing credentialing workflows, productivity metrics, and provider onboarding timelines.
• Proficiency with credentialing software, reporting tools, and document management systems.

Benefits

• Health
• Dental
• Vision
• 401k & Match
• Paid time off