Accreditation and Credentialing Manager

Salary: $107,000 - $115,000.00 (potential for annual performance bonus) Employment Type: Full-time

Position Overview

Are you looking for a career that aligns your passion and values with your purpose? Valera Health is at the forefront of tele-mental health, committed to delivering compassionate mental health care that is accessible and affordable to all.

The Accreditation and Credentialing Manager ensures Valera Health complies with industry and regulatory standards by overseeing all credentialing, re-credentialing, and NCQA accreditation processes. This role manages provider data, tracks licenses and certifications, and liaises with health plans and regulatory agencies to maintain accurate records and support operational efficiency. Leading the credentialing team, the manager ensures compliance with all standards while contributing to high-quality care delivery.

Responsibilities

• NCQA Accreditation Management: Oversee and ensure compliance with NCQA Accreditation standards for Credentialing, maintaining optimal standing.
• Data Management: Supervise the compilation and maintenance of accurate and current provider data, ensuring all information is up-to-date.
• Credentialing and Re-Credentialing: Manage the completion and monitoring of provider credentialing and re-credentialing applications, ensuring timely follow-up as needed.
• Documentation Oversight: Ensure the maintenance of up-to-date copies of state licenses, DEA certificates, malpractice coverage, and other required credentialing documents.
• CAQH Database Management: Monitor and update the CAQH database to ensure accuracy and compliance with CMS schedules.
• Reporting: Provide regular updates to leadership on delegated enrollment timelines, statuses, and other relevant metrics during meetings.
• Roster Maintenance: Maintain and oversee all outgoing delegated rosters.
• Audit and Data Accuracy: Conduct ongoing audits of Valera PM and external tools (EHR) to ensure accurate data and insurance uploads.

Qualifications

Required:

• Bachelor's Degree
• 5+ years of credentialing experience
• 3+ years delegated credentialing experience
• Experience with the NCQA credentialing process
• Knowledge of provider credentialing and its direct impact on the revenue cycle
• Detail-oriented with above-average organizational skills

Preferred:

• Certified Provider Credentialing Specialist (CPCS)
• Tele-mental health experience
• Behavioral Health setting experience
• Startup or health plan experience
• Drive to succeed, collaborating outlook, aligns with our mission

Company Information

At Valera Health, we are at the forefront of tele-mental health. We are committed to delivering compassionate mental health care that is accessible and affordable to all.

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Employee Benefits

Eligible Employee Benefits include but not limited to:

• Health, Vision & Dental Insurance
• 401k through The Standard
• Paid Time Off
• Short Term Disability
• Life Insurance
• Office Equipment
• Many more

Application Instructions

We are very proud of the work that we do and it takes a great team to make it happen! If you are interested in one of our open positions, we’d love to start the conversation.

About Valera Health

We hire people from all backgrounds because that’s what it takes to build a team that can reach and support those in need of high-quality behavioral healthcare. We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, disability status, protected veteran status, or any other characteristic protected by law.

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