Job Title: Credentialing Manager

Job Description

We are seeking a highly skilled Credentialing Manager with a comprehensive understanding of CAQH, payer enrollment, and the full credentialing process. This role involves gathering all necessary documentation to onboard new providers and developing daily credentialing workflows. The Compliance Manager will ensure that all initial and renewal applications align with company policies and operational needs while contributing to the improvement of credentialing procedures across the organization.

Responsibilities

Develop and manage daily credentialing workflows to ensure timely processing of applications.Contribute to the improvement of credentialing procedures, preparing reports and compliance documentation.Maintain and oversee the credentialing database for accuracy and timely updates.Manage electronic credentialing applications, ensuring smooth distribution and submission.Track and manage license and certification expirations, sending timely reminders.Monitor and report on credentialing turnaround times to maintain high-quality results.Provide on-site support and training on credentialing procedures and policy updates.Prepare and coordinate credentialing audits for managed care contracts.Stay current on healthcare regulations and industry standards.Submit accurate provider rosters to health plans and follow up as needed.Oversee team productivity, adjust workloads, and ensure deadlines are met.Use the EHR system to resolve credentialing-related account issues.Lead recredentialing projects and report progress to leadership.Represent the organization in meetings and maintain strong working relationships.Generate monthly credentialing status reports for stakeholders.Support cross-training efforts for team coverage and continuity.Perform additional duties to support the credentialing team and organizational goals.

Essential Skills

Credentialing experience, including CAQH, PECOS, EPREP, CMS, and other credentialing software.Over 10 years of experience in the healthcare or managed care industry, with 5 years in provider credentialing.Certified by NAMSS as a CPMSM or CPCS.Strong background in using EMR/EHR platforms and credentialing systems.Proficient in Microsoft Office tools for data analysis.Excellent communication skills, both written and verbal.Strong decision-making skills and ability to work independently.Highly accountable with attention to detail and follow-through.Organized and efficient in managing multiple priorities.

Additional Skills & Qualifications

Bachelor's degree or equivalent combination of education and hands-on experience.Proven ability to manage credentialing for large provider groups (500+).Comfortable working in fast-paced, evolving environments.Proficient with credentialing platforms like MODIO or similar systems.Collaborative team player who can also take initiative.

Work Environment

This position is on-site in Bethesda, MD, working 5 days a week with a start time of 8:00 AM or 9:00 AM. The role involves overseeing more than 2 junior staff members. The work environment is supportive and promotes diversity and inclusion, encouraging professional growth and team collaboration.

Job Type & Location

This is a Permanent position based out of Bethesda, Maryland.

Pay and Benefits

The pay range for this position is $79000.00 - $93600.00/yr.

Medical Insurance
Dental Insurance
Vision Insurance
Supplemental Insurance
Flexible Spending Accounts (FSA)
Life & Disability Insurance
Continuing Education Assistance

Workplace Type

This is a fully onsite position in Bethesda,MD.

Application Deadline

This position is anticipated to close on Sep 12, 2025.

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\n\nAbout Aston Carter:\n

Aston Carter provides world-class corporate talent solutions to thousands of clients across the globe. Specialized in accounting, finance, human resources, talent acquisition, procurement, supply chain and select administrative professions, we extend the capabilities of industry-leading companies. We draw on our deep recruiting expertise and expansive network to meet the evolving needs of our clients and talent community with agility and excellence. With offices across the U.S., Canada, Asia Pacific and Europe, Aston Carter serves many of the Fortune 500. We are proud to be a ClearlyRated Best of Staffing® double diamond winner for both client and talent service.

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The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

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If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email astoncarteraccommodation@astoncarter.com for other accommodation options.

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