Credentialing & Payer Relations Manager (Remote)

Credentialing & Payer Relations Manager Position Overview:
Under limited supervision, oversees the operations of the USFAS Credentialing and Payer relations department to develop, manage and monitor processes and procedures that support the credentialing, re-credentialing, expirable data management, and contract processes. Oversee all of the credentialing functions. Ensure compliance with the appropriate accrediting and regulatory agencies. Supervise credentialing staff in the day-to-day management of the overall credentialing process and database management.

Credentialing & Payer Relations Manager Essential Functions/Responsibilities (other duties may be assigned):

• Oversee the accurate maintenance of provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications
• Oversee the maintenance of electronic database for application submission, provider and location files
• Development of policies and procedures to ensure accurate and timely credentialing and payer relations contract management
• Develop and implement training for internal staff and customers
• Maintain data reports to measure and track completion and KPI’s
• Ensure clear and appropriate communication to key stakeholders and vendors
• Manage vendors as required
• Ability to manage payers and contract negotiations
• Performs other duties as assigned

Credentialing & Payer Relations Manager Required Education, Skills and Experience:

• Bachelor’s degree in Business, English, or related field
• Effective communication skills to all stakeholders both internal and external
• Ability to multi-task is key to success in this position
• Ability to work in a fast-paced environment managing a critical functional for the organization
• High attention to detail with minimal errors
• Proven time management skills with proven ability to meet deadlines
• Excellent organizational skills
• Technologically savvy and proficient in Microsoft 365 products, including Word, Excel, Outlook, and Teams 

Credentialing & Payer Relations Manager Physical Requirements: 

The physical demands described here represent those required to perform essential job functions. Reasonable accommodation may be made for individuals with disabilities. While performing this role, the employee must regularly: 

• Sit, talk, hear, and use hands to write, type, or operate office equipment 
• Occasionally reach with hands and arms; climb, balance, stoop, kneel, crouch, crawl, and smell 
• Perform repetitive motions, including reaching overhead and typing 
• Lift up to 50 pounds occasionally and carry objects weighing up to 25 pounds 
• Maintain peripheral vision, depth perception, and focus adjustments 

Credentialing & Payer Relations Manager Benefits Offered: 

• Health Insurance (Single & Family plans available) 
• Life Insurance 
• Disability Insurance 
• 401(k) Plan with Company Match 
• Employee Discount Program 
• Paid Time Off 
• Paid Holidays