Senior Credentialing & Provider Enrollment Manager

TCH Medical Center; Houston (TX); On-site; USD 90,000 - 120,000; Full time

Job summary

Texas Children’s Medical Staff seeks a Centralized Credentialing Manager to maintain the credentialing program for TCPSO, ensuring compliance with federal, state, and accrediting bodies while leading credentialing staff.

The role emphasizes policy upkeep, audits, staff training, and collaboration with other departments to meet NCQA and TJC requirements across the integrated delivery system.

Qualifications

• 8 years experience in a healthcare credentialing or related area.
• Supervisory or managerial experience preferred.
• Knowledge of credentialing processes and regulatory standards.

Responsibilities

• Manages a Credentialing Program meeting regulatory and accrediting body requirements.
• Responsible for credentialing responses to regulatory audits.
• Train Centralized Credentialing staff to maintain up-to-date knowledge for quality, regulatory, or malpractice issues.
• Handles credentialing and re-credentialing for TCPSO members and Texas Children’s Medical Staff.
• Oversees credentialing for practitioners under delegated payor agreements.
• Maintains a current database of credentialed practitioners.
• Ensures credentialing follows Joint Commission requirements and NCQA/TJ C guidelines.
• Collaborates with other departments to meet NCQA and TJC requirements.

Skills

Healthcare leadership

Supervisory experience

Regulatory compliance

Credentialing knowledge

Education

Bachelor's degree

Job description

Texas Children’s Medical Staff seeks a Centralized Credentialing Manager to maintain the credentialing program for TCPSO, ensuring compliance with federal, state, and accrediting bodies while leading credentialing staff.

The role emphasizes policy upkeep, audits, staff training, and collaboration with other departments to meet NCQA and TJC requirements across the integrated delivery system.