Provider Credentialing & Enrollment Manager

Pmpediatriccare

Base: $95,000-110,000; bonus/equity: not specified...
Fully remote
Provider credentialing and enrollment expertise
Urgent care environments
State bylaws for credentialing
The Provider Credentialing and Enrollment Manager will oversee the processing of applications and reapplications for providers, ensuring compliance with national accreditation standards and state and federal regulatory requirements

Job Summary

  • The Provider Credentialing and Enrollment Manager will oversee the processing of applications and reapplications for providers, ensuring compliance with national accreditation standards and state and federal regulatory requirements.
  • This role ensures provider staff is credentialed and enrolled with payers to ensure sufficient clinical coverage and minimal claims reimbursement denials.
  • The position requires a subject matter expert in all state bylaws of the credentialing process and application management, specifically tailored for urgent care environments.

Matching Summary

The Provider Credentialing and Enrollment Manager will oversee the processing of applications and reapplications for providers, ensuring compliance with national accreditation standards and state and federal regulatory requirements.

Salary

Base: $95,000-110,000; Bonus/Equity: Not specified; Benefits: Not specified

Skills & Requirements

Must-have

  • Provider credentialing and enrollment expertise
  • Urgent care environments
  • State bylaws for credentialing
  • Primary source verification
  • CMS NPPES reporting

Nice-to-have

  • Customer focus
  • Attention to detail
  • Adapt to changing deadlines
  • Root cause analysis

Key Requirements

  • Minimum five years operational experience
  • Expertise in urgent care bylaws
  • Experience with CAQH database
  • Proven ability to manage multiple projects

Work Rights

Not specified

Tailored Resume

Cover Letter