Credentialing Manager - Telemedicine Start-up

Job Description

Job Description

Our client is a venture backed healthcare company that enables people with chronic conditions such as diabetes and kidney disease to eat and live well.

We are looking for a Credentialing Manager to oversee the clinical onboarding and operations for our plans and providers. This critical role will be responsible for developing the overall clinical onboarding program and ensuring we can continue to deliver exceptional care to our patient population!

We are looking for someone with a strong background in credentialing and payer enrollment set-up. Someone who has built a program from the ground up, managed and overseen the work of others. Someone who has worked in an early-stage, fast growth organization, and knows how to work strategically and cross functionally with a leadership team.

What You’ll Do

As our Credentialing Manager, you’ll be the go-to person for all things credentialing! You’ll handle individual and group applications, PTAN applications (whether it’s new or reassigned), payer portal attestations, and everything in between. Plus, you’ll be in charge of keeping our credentialing data warehouse in tip-top shape, ensuring all docs are up-to-date. Whether it’s W2 employees or 1099 contractors, you’ll manage our rosters and work with our clinical team to gather the right documentation when needed.

About you:

• You’ve got deep knowledge of the credentialing process from A to Z
• Multi-state credentialing experience
• You have experience working with and managing CVOs
• Hands-on with PECOS, CAQH, and CAQH ProView
• Knowledge of post-contract EDI/ERA/EFT setups
• Experienced with provider and group credentialing
• 5+ years of experience communicating with health plans for credentialing, CAQH, Availity, and payer portals
• You’re tech-savvy and can quickly get the hang of new platforms

Perks:

• Full-time, fully remote position
• Medical, dental, and vision benefits for you and your family at no cost
• 401k plan option
• Equity options
• Flexible work hours and paid time off
• A chance to make a real difference in people’s health and nutrition