Regional Manager of Payer Credentialing

Schedule: Full time, Days

Main Function: The Manager of Payer Credentialing will lead and oversee all aspects of payer credentialing and re-credentialing for providers across our consolidated entity, which includes five health systems and six hospitals. This role is critical in ensuring timely and accurate enrollment with all commercial and government payers, facilitating seamless revenue cycle operations, and maintaining compliance with regulatory and payer-specific requirements. The manager will be responsible for developing and implementing efficient processes, managing a team of credentialing specialists, and serving as a key liaison with internal stakeholders and external payers.

Job Specific Competencies: 

• In-depth knowledge of payer credentialing processes, regulations (e.g., NCQA, URAC), and compliance standards.
• Proficiency in credentialing software systems (e.g., CredentialStream).
• Understanding of CAQH
• Strong leadership, team building, and staff development skills.
• Excellent organizational, analytical, and problem-solving abilities.
• Exceptional written and verbal communication skills, with the ability to interact effectively with all levels of staff, providers, and external stakeholders.
• Ability to manage multiple priorities in a fast-paced, complex environment.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook).
• Always lives the CARES values.

Education and Experience: 

• Bachelor’s degree in healthcare administration, Business Management, or a related field is preferred, 7 years’ equivalent work experience will be considered.
• Minimum of 5-7 years of progressive experience in payer credentialing and provider enrollment, preferably within a large healthcare system or multi-facility environment.
• At least 2-3 years of experience in leadership or supervisory role
• Demonstrated experience managing credentialing for multiple health systems or hospitals simultaneously.

Pay Range: $75,000 - $90,000

Starting Pay: Based on experience 

Thompson Health is an EOE encouraging individuals with disabilities and veterans to apply