Palm Beach Accountable Care Organization · 18 hours ago
Delegated Credentialing Manager
Palm Springs, FL
Full-time
Onsite
Senior Level
5+ years expPalm Beach Accountable Care Organization is seeking a Delegated Credentialing Manager who will oversee and manage the credentialing process for healthcare providers within delegated networks. This role ensures compliance with regulatory standards and organizational policies while leading a team responsible for verifying provider qualifications and maintaining accurate records.
Health CareInformation Technology
Responsibilities
Manage and oversee the delegated credentialing process, ensuring compliance with NCQA, URAC, and other regulatory standards
Coordinate and conduct audits of credentialing files and processes to maintain accuracy and completeness
Lead, train, and support the credentialing team to meet performance goals and maintain high-quality standards
Collaborate with internal departments, external providers, and delegated entities to resolve credentialing discrepancies and issues
Develop and implement policies and procedures to improve credentialing workflows and ensure timely provider enrollment and re-credentialing
Prepare and present credentialing reports and metrics to senior leadership and regulatory agencies as required
Maintain up-to-date knowledge of industry regulations, accreditation standards, and best practices related to credentialing
Qualification
Required
Bachelor's degree in Healthcare Administration, Business, or a related field
Minimum of 5 years of experience in healthcare credentialing or provider network management
Strong knowledge of NCQA, URAC, and other relevant credentialing standards and regulations
Proven experience managing delegated credentialing processes and teams
Excellent organizational, communication, and leadership skills
Preferred
Certified Provider Credentialing Specialist (CPCS) or equivalent certification
Experience working within managed care organizations or health plans
Familiarity with credentialing software and database management systems
Advanced knowledge of healthcare compliance and regulatory environments
Demonstrated ability to lead process improvement initiatives
Company
Palm Beach Accountable Care Organization
Palm Beach Accountable Care Organization physicians have identified prevention as a key factor in improving overall patient health.
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
Amanda Larschan, MHA, PMP
Chief Data Officer
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