CLS Health · 2 days ago
Credentialing Manager
Webster, TX
Full-time
Onsite
Senior Level, Lead/Staff
10+ years expCLS Health is Houston’s largest physician-owned, physician-led healthcare system focused on patient-centered care. They are seeking a detail-oriented Credentialing Manager to oversee the credentialing team and ensure compliance with internal and regulatory standards.
Health CareMedical
Responsibilities
Supervise and provide guidance to the credentialing staff, ensuring timely and accurate completion of all credentialing and recredentialing applications
Monitor credentialing timelines and performance metrics, prioritizing tasks to meet payer and regulatory deadlines
Review provider applications and support documentation for accuracy and completeness
Collaborate with internal departments such as Human Resources, Provider Relations, and Revenue Cycle to ensure smooth onboarding and credentialing of new providers
Maintain provider credentialing files and databases in accordance with organizational and accreditation standards (e.g., NCQA, TJC)
Resolve discrepancies, follow up with providers for missing information, and address any issues or delays in credentialing workflows
Prepare for and participate in internal audits, external audits, and accreditation reviews
Stay current with applicable laws, regulations, and payer requirements affecting credentialing
Train, mentor, and evaluate credentialing team performance; identify areas for process improvement
Assist in the development and implementation of credentialing policies and procedures
Perform related duties as required
Qualification
Required
Associate's or bachelor's degree in healthcare administration, Business, or related field preferred
Minimum of 10 years of experience in healthcare credentialing, with at least 1 year in a supervisory or lead role
Strong knowledge of credentialing standards, healthcare standards and payer requirements (Medicare, Medicaid, Healthcare insurers)
Experience with credentialing software/systems (e.g., CAQH, Modio OneApp, Echo, etc.)
Strong attention to detail and accuracy in record-keeping
Excellent organizational and time management skills
Effective communication and leadership abilities
Ability to prioritize and handle multiple tasks in a fast-paced environment
Proficient in Microsoft Office Suite (Word, Excel, Outlook)
Benefits
401(k) with company match
Medical, Dental, Vision, and Life Insurance
Paid time off
Disability insurance
Company
CLS Health
Clear Lake Specialties a leading provider of inpatient and outpatient care in Southeast Houston.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Megan Owen, MBA
Chief Executive Officer
Rohit Robert Dhir, MD
Partner
Recent News
2025-01-08
2024-11-21
2024-05-23
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