Senior Manager, Credentialing & Provider Data Management Systems
Core
Oversee credentialing processes and provider data management systems for physicians, mid-level practitioners, and organizational providers.
Role type
Senior Manager, Credentialing & Provider Data Management
Builds
Provider enrollment systems, data directories, and compliance reporting
Domain
Healthcare administration / Managed care operations
Required skills
SQL Server, NCQA standards, provider data management, credentialing processes, team leadership, policy development, data accuracy management
Preferred skills
Portico, Amisys, CenProv, technical team leadership
Responsibilities
Lead technical team for system updates and enhancements; oversee credentialing and re-credentialing of providers; manage provider data updates and directory production; ensure compliance with NCQA and state/federal regulations; develop training materials and procedures.
Seniority
Senior, hands-on IC with management responsibilities