Credentialing Manager
On-site · Lehi, Utah, United States
Job Summary
Credentialing Manager oversees credentialing and re-credentialing for behavioral health providers, ensuring licensing, accreditation, and regulatory compliance. Responsibilities include verifying licensure and certifications, managing enrollment with insurance networks, conducting audits and compliance checks, maintaining accurate provider records, tracking expirations, and preparing status reports for senior leadership. The role requires collaboration with HR, billing, and operations, plus staying current with regulatory changes and applying them to credentialing workflows.
Required Qualifications
- Bachelor's degree in healthcare administration, business, or related field or equivalent work experience in credentialing, compliance, or healthcare operations
- Minimum 3-5 years of credentialing experience in healthcare or behavioral health
- Experience with credentialing for behavioral health providers (licensure, certifications, enrollment with insurance networks)
- Knowledge of regulatory requirements for healthcare providers and credentialing standards
- Strong organizational skills and attention to detail
- Excellent written and verbal communication skills
- Ability to manage multiple tasks in a fast-paced environment
- Familiarity with credentialing software and databases
- Experience collaborating with HR, billing, operations, and external agencies or payers
- Ability to maintain confidentiality and handle sensitive information
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