Senior Healthcare Credentialing Manager

GI Alliance; Southlake (TX); On-site; USD 70,000 - 90,000; Full time

Job summary

GI Alliance is seeking a Credentialing Manager to oversee credentialing and recredentialing applications for health care providers across plans. You will ensure NCQA guidelines are met and support the Director and SVP of Payer Relations with onboarding new providers and timely credentialing before effective dates.

Responsibilities include maintaining credentialing data, coordinating with health plans, and training staff on credentialing processes.

Qualifications

• Strong presentation skills.
• Excellent communication skills, both written and verbal.
• Ability to work with physicians and non-physician providers.
• Proficient technical (computer) skills.
• Ability to multi-task and prioritize.
• Self-motivated with initiative.
• Strong sense of ethics.

Responsibilities

• Approve time off requests, ensuring adequate staffing during peak times.
• Review and approve semi-monthly payroll.
• Provide employee feedback, coaching, and counseling.
• Conduct annual employee performance reviews and deliver reviews to employees.
• Attend management meetings, as needed.
• Ensure providers credentialing is completed prior to the effective date with the health plans.
• Assist with training and educating credentialing staff and provider offices on credentialing processes.
• Assist COO and Director of Payer Relations as needed for any escalated issues related to credentialing GI Alliance providers.
• Other duties as assigned.

Skills

Presentation skills

Communication skills

Multi-tasking

Ethics

Initiative

Education

High school diploma or equivalent

Job description

GI Alliance is seeking a Credentialing Manager to oversee credentialing and recredentialing applications for health care providers across plans. You will ensure NCQA guidelines are met and support the Director and SVP of Payer Relations with onboarding new providers and timely credentialing before effective dates.

Responsibilities include maintaining credentialing data, coordinating with health plans, and training staff on credentialing processes.