InnovaCare Health · 4 hours ago
Credentialing Manager
Orlando, FL
Full-time
Onsite
Senior Level
5+ years expInnovaCare Health is a company focused on healthcare management, and they are seeking a Credentialing Manager to oversee the credentialing process for their clinical staff. This role involves ensuring that applications are verified and maintained accurately, while also managing communication and documentation related to credentialing matters.
Health CareHealth Insurance
Responsibilities
Serve as the primary contact for all credentialing and recredentialing matters by market
Maintain up-to-date knowledge of state and federal regulations, as well as accreditation standards
Coordinates and monitors the timely implementation and maintenance of accurate and up to date credential files for members of our clinical staff
Manages the day-to-day exchange of documents and communications concerning the records and verification required for medical staff applications
Audits files of providers records and evaluates for issues requiring further investigation
Critical thinking, ability to follow through and function independently, has initiative, and has attention to detail, and has excellent organizational skills
Contribute to continuous process improvement activities of the team and partnering teams such as Revenue Cycle Management and Payor Operations
Coaches and guides team members as needed
Trains / Onboards new credentialing specialist resources
Draft and distribute monthly and quarterly reports to RCM Officer, Credentialing Leadership, Clinical Operations Leaders, and other senior executives
Other duties as assigned
Qualification
Required
Bachelor's degree in business, health care administration, human resources, or related field
5+ years' experience in credentialing, provider relations, or similar role
Proficient in Microsoft Office, with aptitude to learn new software and systems
Solid understanding of accreditation standards (NCQA, URAC, etc.)
Excellent interpersonal skills
Strong project management and organizational skills
Ability to multitask and manage competing priorities
Preferred
Master's degree in business, human resources, or related field
7+ years' experience in credentialing, provider relations, or similar role
Experience with CAQH ProView, NAMSS PASSport, or similar credentialing database
Working knowledge of medical terminology
Familiarity with state and federal regulations governing healthcare providers (Medicare, Medicaid, HIPAA, etc.)
Company
InnovaCare Health
Offering seniors comprehensive benefits that not only meet their medical needs but also contribute to their emotional and mental well-being.
1001-5000 employees
Funding
Current Stage
Late StageTotal Funding
$3M2021-11-19Acquired
2019-01-10Series Unknown· $3M
Leadership Team
Rick Shinto
Chief Executive Officer
Recent News
MarketScreener
2025-07-09
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2025-03-08
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