Credentialing Operations Manager

TWG Talent Solutions; Tampa (FL); In loco; USD 75.000 - 95.000; Tempo pieno

Descrizione del lavoro

A national healthcare services provider is seeking a Credentialing Operations Manager to oversee credentialing for providers and facilities. This hybrid role focuses on ensuring compliance with regulatory standards and optimizing processes. Ideal candidates should have 3–5 years of experience in credentialing operations and proven leadership in fast-paced environments. A Bachelor’s degree is required, and a Master’s is preferred. The position promotes continuous improvement across all credentialing activities.

Competenze

• 3–5+ years in credentialing operations, with leadership experience.
• Strong knowledge of credentialing regulations (NCQA, URAC, CMS, Joint Commission).
• Proven ability to manage processes, people, and priorities in a fast-paced environment.

Mansioni

• Own credentialing & recredentialing for providers and facilities.
• Drive operational excellence by identifying gaps and improving workflows.
• Lead delegations audits, including oversight and corrective action planning.
• Partner cross-functionally with internal teams and external stakeholders.

Conoscenze

Credentialing operations

Regulatory compliance

Operational excellence

Leadership

Formazione

Bachelor’s degree

Master’s degree

Descrizione del lavoro

Credentialing Operations Manager (Hybrid)

We’re looking for a Credentialing Operations Manager to lead and optimize credentialing for national providers and facilities. This role ensures compliance with regulatory standards while driving efficiency, accuracy, and continuous improvement across all credentialing activities.

What You’ll Do

• Own credentialing & recredentialing for providers and facilities - ensuring timely, accurate, and compliant processes
• Drive operational excellence by identifying gaps and improving workflows
• Lead delegation audits, including oversight, reporting, and corrective action planning
• Partner cross-functionally with internal teams and external stakeholders to resolve issues and accelerate timelines
• Maintain policies & compliance aligned with NCQA, URAC, CMS, and Joint Commission standards
• Prepare for audits and support ongoing regulatory readiness

What You Bring

• 3–5+ years in credentialing operations, with leadership experience
• Strong knowledge of credentialing regulations (NCQA, URAC, CMS, Joint Commission)
• Proven ability to manage processes, people, and priorities in a fast-paced environment
• Bachelor’s degree required (Master’s preferred)