Senior Manager, Credentialing & Enrollment
Imagine PediatricsSalary not specified
Full Time
Expert & Leadership (9+ years)
Not SpecifiedCompensation
Junior (1 to 2 years)Experience Level
Full TimeJob Type
UnknownVisa
Healthcare, Mental Health ServicesIndustries
Requirements
Candidates should have 1-2 years of credentialing experience and prior experience working in a remote setting. They should possess advanced skills in Excel and Google Sheets, and familiarity with internal and external credentialing processes, as well as NCQA policies.
Responsibilities
The Medical Staff Services Specialist will apply for provider licenses, monitor license applications, ensure applications are full and complete, verify provider requirements for approval, resolve license deficiencies, assist with interpreting state requirements, maintain provider files with strict confidentiality, manage provider information in the provider data platform, establish and maintain credentialing files, maintain the Medical Staff electronic database, process applications, complete delegated health plan monthly rosters, assist in training new team members, and support the compliance team with periodic reviews of NCQA policies and CAQH ongoing maintenance/management.
Skills
Provider Licensing
Credentialing
Regulatory Compliance
NCQA Policies
CAQH Management
State Licensing Platforms (IMLC, eNLC, State Board Websites)
Excel
Google Sheets
HIPAA Confidentiality
Primary Source Verification
Valera Health
Telehealth platform for mental health services
About Valera Health
Valera Health provides mental health services through a digital platform, focusing on both therapy and psychiatry for individuals aged 6 and older. Their telemental health platform enables patients to connect with a care team, which includes a Health Connector, therapist, and psychiatrist, from anywhere, making mental health care more accessible. Unlike many competitors, Valera Health emphasizes a collaborative approach to patient wellness, ensuring that all members of the care team work together. The goal of Valera Health is to enhance the convenience and effectiveness of mental health care, allowing patients to receive support from the comfort of their homes.
New York City, New YorkHeadquarters
2015Year Founded
$76.2MTotal Funding
LATE_VCCompany Stage
HealthcareIndustries
201-500Employees
Benefits
Health Insurance
Dental Insurance
Vision Insurance
401(k) Retirement Plan
Paid Vacation
Disability Insurance
Life Insurance
Risks
Competition from large healthcare companies like CVS Health threatens market share.
Regulatory changes in Vermont could impact the Blue Cross VT partnership.
Rapid expansion into college campuses may strain resources and affect service quality.
Differentiation
Valera Health combines digital technology with human touch for mental health services.
The company offers specialized programs for Serious Mental Illness and Maternal Health.
Valera Health provides therapy and psychiatry services for individuals aged 6 and above.
Upsides
Partnership with Blue Cross VT expands access to underserved areas in Vermont.
$45M growth equity financing supports technology enhancement and service expansion.
LGBTQIA+ therapy launch taps into growing demand for inclusive mental health services.
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