Healthcare Credentialing Manager

Careington International Corporation; Frisco (TX); Hybrid; USD 80,000 - 110,000; Full time

Job summary

Careington International Corporation in Frisco, TX, is seeking a Credentialing Manager to lead the credentialing team, own strategy, processes, and KPI achievement to ensure accurate, timely credentials. You will collaborate with Dental Network Development and Account Management, monitor accounts, and maintain data integrity while ensuring regulatory compliance.

This hybrid role starts with a three-days-in-office, two-days-from-home schedule and plans to move to five days in the office in Spring

Qualifications

• Bachelor’s degree in Business or a related field
• 5+ years of experience in credentialing, clerical office work, or a related field
• Proficient computer skills and experience with MS Applications - Excel, Word, Outlook, etc

Responsibilities

• Lead, coach, and develop a team to manage credentials for members in the Careington Dental Network.
• Model high-quality leadership behaviors that reinforce accountability, ownership, curiosity, and member-first thinking.
• Fully own the Credentialing function including strategy, process development, execution, and KPI achievement of the team.
• Ensure members of the dental network provide accurate, timely, and compliant credentials.
• Monitor key accounts and metrics to ensure operational excellence.
• Identify, prioritize, and lead strategic initiatives that improve scalability and reduce complexity.
• Collaborate cross-functionally with members of Dental Network Development and Account Management to ensure strong external relationships.
• Maintain rigorous quality assurance standards to ensure credibility.
• Responsible for the accuracy and integrity of the credentialing and re-credentialing database.
• Ensure compliance with rules and regulations.
• Create, own, and maintain communication and follow-up guidelines.
• Perform quality audit and review.

Skills

Credentialing experience

MS Office

Leadership

Education

Bachelor’s degree in Business or related field

Tools

Excel

Word

Outlook

Job description

For more than 45 years, Careington International has been a leader in the health and wellness benefits space. Since its founding in 1979, Careington has been delivering dental discount solutions as its core competency. Today, Careington has expanded to offer a growing portfolio of 150+ health, wellness, lifestyle and virtual health products and services designed to deliver cost savings across a spectrum of life needs. Through its affiliated nationally licensed third-party administrator (TPA), Careington also delivers full-scale administrative services, including customer service, licensed enrollment, claims administration, individual and group billing.

This role will initially be worked in the office a minimum of 3 days a week and 2 days from home. At some point and time in 2027 (Spring to Summer) will revert to five days in the office.

Responsibilities

• Lead, coach, and develop a team to manage credentials for members in the Careington Dental Network.
• Model high-quality leadership behaviors that reinforce accountability, ownership, curiosity, and member-first thinking.
• Fully own the Credentialing function including strategy, process development, execution, and KPI achievement of the team.
• Ensure members of the dental network provide accurate, timely, and compliant credentials.
• Monitor key accounts and metrics to ensure operational excellence.
• Identify, prioritize, and lead strategic initiatives that improve scalability and reduce complexity.
• Collaborate cross-functionally with members of Dental Network Development and Account Management to ensure strong external relationships.
• Maintain rigorous quality assurance standards to ensure credibility.
• Responsible for the accuracy and integrity of the credentialing and re-credentialing database.
• Ensure compliance with rules and regulations.
• Create, own, and maintain communication and follow-up guidelines.
• Perform quality audit and review.

Required Skills

• Bachelor’s degree in Business or a related field
• 5+ years of experience in credentialing, clerical office work, or a related field
• Proficient computer skills and experience with MS Applications - Excel, Word, Outlook, etc

Preferred Skills

• 2+ years of experience in a leadership/management role

Equal Opportunity Statement

This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.