Provider Data & Credentialing Manager (Cincinnati, OH office)

DigitalOptometrics is an optometric-telemedicine company focused on performing comprehensive remote eye examinations. Continuously expanding, our teams and business have grown year over year, now providing exams in the majority of US states and Canadian Provinces. As an important step in our growth process, we are seeking a Provider Data & Credentialing Manager. This is a full-time salaried position that can be performed from either of our base offices in Lake Success, NY, Cincinnati, OH or if out of state, remotely.

The Provider Data & Credentialing Manager will lead a team of specialists who assist in data management and direct credentialing of Optometrists with various insurance carriers throughout the United States. This includes ensuring Medicare and Medicaid enrollments as well as commercial enrollments for Providers.

You'll be joining a highly motivated and adaptive team that will be growing along with our company and clients. Having an in-depth knowledge of vision, medical, and federal (Medicaid and Medicare) enrollment processes will be vital to our success. Creative & proactive problem solving in overcoming credentialing challenges with the collaboration of our teams will be vital.

Primary Responsibilities:

• Provide leadership and structure to our Networking & Credentialing Team.
• Develop and administer internal policy & procedures for efficient credentialing and networking operations.
• Support and collaborate with multiple internal departments (Recruitment, Finance, HR, Operations, Implementation) for doctor onboarding, credentialing and sustainment for clients.
• Work with insurance companies on the national and state level during the credentialing process.
• Work within the credentialing software platform QGenda for provider and document management.
• Manage Certificates of Liability Insurance process, from request to receipt to ensure Doctors have active policies in place as needed.

Required Qualifications:

• 7+ years of credentialing experience
  • Government Enrollments: Medicare & Medicaid
  • Commercial Carriers: Vision & Medical
• 4+ years of leadership experience.
• Bachelor's degree or equivalent experience.
• Experience working in a multi-state credentialing organization.
• For Remote Employment: Reliable internet connection with bandwidth no less than 10 Mbps Up/Down.