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Job Summary

The Manager, Credentialing is responsible for overseeing the credentialing and re-credentialing processes for healthcare providers within the organization. This role ensures compliance with regulatory and accreditation standards, manages credentialing operations, and maintains accurate records of provider credentials. The Manager collaborates with medical staff, facility leadership, and external agencies to streamline processes, uphold quality standards, and support patient safety and care quality.

Essential Functions

+ Develops, implements, and monitors credentialing and re-credentialing policies and procedures to ensure compliance with regulatory standards.

+ Oversees the credentialing operations, including application processing, primary source verification, and documentation management.

+ Ensures the maintenance of accurate and complete credentialing records, coordinating with medical staff and relevant departments.

+ Reviews and improves credentialing workflows and processes to enhance accuracy, efficiency, and compliance.

+ Manages relationships with accrediting bodies, regulatory agencies, and external vendors to maintain industry-standard credentialing practices.

+ Prepares and presents reports on credentialing metrics, status updates, and quality improvement initiatives to facility leadership.

+ Acts as a resource on credentialing matters, staying informed of changes in regulatory and accreditation standards.

+ Performs other duties as assigned.

+ Complies with all policies and standards.

Qualifications

+ Associate Degree in Healthcare Administration, Business, or a related field required

+ 3-5 years of experience in credentialing required

+ 1-2 years of supervisory or management experience preferred

Knowledge, Skills and Abilities

+ Knowledge of credentialing processes, regulatory standards, and accreditation requirements.

+ Strong leadership and team management skills to guide and develop credentialing staff.

+ Analytical skills for quality control, process improvement, and data management.

+ Excellent communication and collaboration skills to interact with internal teams and external agencies.

+ Organizational skills to manage detailed records, regulatory compliance, and workflow efficiencies.

Licenses and Certifications

+ CPMSM - Certified Professional Medical Services Management required or

+ Certified Provider Credentialing Specialist (CPCS) required

Equal Employment Opportunity

This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national origin, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, the facility complies with all applicable federal, state and local laws governing nondiscrimination in employment. This applies to all terms and conditions of employment including, but not limited to: hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. If you are an applicant with a mental or physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the director of Human Resources at the facility to which you are seeking employment; Simply go to http://www.chs.net/serving-communities/locations/ to obtain the main telephone number of the facility and ask for Human Resources.