Manager, Credentialing Data

U.S. Renal Care; Plano (TX); Remote; USD 80,000 - 100,000; Full time

Job summary

A leading company in healthcare is seeking a Manager for Credentialing Data. This remote position requires on-site training and focuses on managing databases, ensuring data integrity, and overseeing credentialing processes. Ideal candidates will have a strong background in healthcare and experience with credentialing systems.

Qualifications

• 5+ years of experience in healthcare and/or industry preferred.
• Experience with credentialing systems is preferred.

Responsibilities

• Manage databases and ensure data integrity and availability.
• Oversee daily operations and management of credentialing programs.
• Provide reports and statistical data to other departments.

Skills

Detail-oriented

Effective communication

Independent judgment

Education

Bachelor's degree in a healthcare-related field

Master's Degree in healthcare-related field

Tools

HealthStream

CredentialStream

Microsoft Office

Job description

The Manager, Credentialing Data ('Manager') is responsible for managing databases and ensuring the integrity and availability of data. The Manager will design, test, and implement various database solutions to meet business needs. This position provides data management, entry, verification, validation, quality control of data, and report production for the day-to-day operations of the Medical Staff Credentialing Office. This position serves to ensure the accuracy of the Medical Staff Credentialing data as the Data Source of Truth for related initiatives, services, and programs.

Position is remote, but on-site training is required at our Plano Corporate Office a few times a year. Candidate should reside in the Dallas/Fort Worth area.

Essential Duties and Responsibilities

1. Take ownership for data quality at all stages of the data pipeline, from raw data retrieval to user-facing reporting.
2. Continuously improve the quality of data to enhance data retrieval, report generation stability, and system performance.
3. Act as subject matter expert for US Renal Care's credentialing system operations.
4. Manage Medical Staff Credentialing internal project deliverables such as Project Wizard tasks.
5. Manage and enhance routine schedules and auditing projects related to provider credentials, certifications, sanctions & exclusions, and demographic changes.
6. Manage data verification and reconciliation projects as assigned.
7. Provide reports and statistical data to other departments for review and follow-up.
8. Perform general administrative tasks in support of the department.
9. Create and maintain multiple databases, including the credentialing system and related corrections.
10. Attend meetings and training sessions hosted by the credentialing system provider to implement system enhancements and automations.
11. Conduct routine auditing and management of scheduled reports.
12. Oversee daily operations and management of credentialing programs, projects, and initiatives.
13. Support and maintain credentialing and technology systems.
14. Ensure the accuracy of data as the Data Source of Truth for related initiatives, services, and programs.
15. Perform quality assurance activities and ensure accurate data reporting procedures.
16. Collaborate with Medical Staff Leadership on system goals, timelines, and objectives.
17. Promote and provide exceptional customer service to internal and external parties; develop effective relationships across all levels of the organization.
18. Monitor regulatory guidelines to ensure compliance with rules and standards.
19. Maintain compliance with regulatory standards, Bylaws, Code of Conduct, policies & procedures.
20. Work with Medical Staff Leadership to monitor credentialing system functionality, resolve issues, and implement system enhancements based on end-user and organizational needs.
21. Proactively monitor the credentialing system for technical issues, troubleshooting and resolving with corporate partners.
22. Maintain expertise on system enhancements, end-user demands, and recurring issues, working closely with compliance teams.
23. Oversee user permissions, rights, and classifications.
24. Support automation of repetitive system administration functions.
25. Promote GUEST customer service standards and develop effective relationships at all organizational levels.
26. Communicate expectations clearly; accept accountability and hold others accountable for performance.
27. Maintain regular and reliable attendance.

Qualifications/Requirements

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Requirements include:

• Bachelor's degree in a healthcare-related field or equivalent work experience.
• Master's Degree in healthcare-related field preferred.
• Five or more (5+) years of experience in healthcare and/or industry preferred.
• Experience with credentialing systems; HealthStream/CredentialStream preferred.
• NAMSS Certified Provider Credentialing Specialist (CPCS) preferred.
• Detail-oriented with the ability to manage changing priorities and deadlines.
• Knowledge of Joint Commission, CMS, and NCQA standards.
• Understanding of medical staff credentialing and privileging procedures.
• Ability to use independent judgment and maintain confidentiality.
• Effective communication skills, both oral and written.
• Proficient computer skills, including Microsoft Office and database management; proficiency in USRC applications required within 90 days of hire.