Senior Manager, Credentialing & Enrollment - Remote

Overview

The Senior Manager, Credentialing & Enrollment oversees the operations of the Imagine Pediatrics Credentialing department to develop and manage Provider Licensure, Medicaid Enrollment, Health Plan Credentialing and Re-Credentialing with payer partners for a multi-specialty telehealth group across 5+ markets.

In Short

• Manage staff that process Provider Licensure, Medicaid Enrollment, and Health Plan Credentialing requirements for multi-specialty providers.
• Supervise Credentialing staff in the day-to-day management of Provider Licensure and Enrollment applications.
• Manage Credentialing Program, ensuring compliance with regulatory agencies.
• Execute Credentialing Program policies and procedures to ensure accuracy.
• Facilitate Credentialing Committee and present Credentialing Files for review.
• Act as a liaison to state Licensure boards and Medicaid Agencies.
• Analyze and prepare reports on status and trends in submitted applications.
• Ensure department milestones, deadlines, and SLAs are met.
• Develop and design department policies and procedures.
• Manage configuration and maintenance of Credentialing platform.

Requirements

• At least seven years' experience as a Credentialing Specialist.
• At least five years’ experience as a people manager.
• Experience managing Credentialing functions in Verifiable and Athena.
• CPCS or CPMSM certification highly preferred.
• Good working knowledge of Licensure and Medicaid guidelines.
• Excellent communication skills with internal stakeholders.
• Detail-oriented with strong organizational skills.

Benefits

• Competitive medical, dental, and vision insurance.
• Healthcare and Dependent Care FSA; Company-funded HSA.
• 401(k) with 4% match, vested 100% from day one.
• Employer-paid short and long-term disability.
• Life insurance at 1x annual salary.
• 20 days PTO + 10 Company Holidays & 2 Floating Holidays.
• Paid new parent leave.
• Additional benefits to be detailed in offer.