Manager of Credentialing and Payer Operations

Credentialing:

• Build and strengthen structures to ensure providers are credentialed in a timely and compliant manner.
• Administer our Credentialing Committee, collaborating with clinical leadership to enforce guidelines.
• Own relationships with credentialing/CVO vendors to monitor and improve SLA performance.

Payer Enrollment:

• Serve as the subject matter expert with provider enrollments with health plans.
• Design quality controls and error-catching checkpoints that reduce rework and rejected applications.
• Actively monitor team performance and SLAs, flagging aging items and escalations quickly.

Leadership:

• Coach and lead a team of US based and international specialists.
• Coordinate cross-functionally with RCM, payer strategy/business development teams.
• Set and enforce performance standards across the team.