Imagine Pediatrics

Senior Manager, Credentialing & Enrollment

United States

Not SpecifiedCompensation
Expert & Leadership (9+ years)Experience Level
Full TimeJob Type
UnknownVisa
Healthcare, Financial Services, TelehealthIndustries

Requirements

Candidates should have at least seven years of experience in credentialing, with at least five years in people management of a team of three or more. Previous experience managing credentialing functions in Verifiable and Athena is preferred. CPCS or CPMSM certification, or progress towards certification, is highly preferred. Strong knowledge of licensure and Medicaid guidelines across multiple markets, excellent communication skills with internal stakeholders at all levels, and strong organizational and detail-oriented skills are also required.

Responsibilities

The Senior Manager, Credentialing & Enrollment will oversee the Credentialing department's operations, managing staff responsible for provider licensure, Medicaid enrollment, and health plan credentialing and re-credentialing. This includes supervising daily operations, managing the credentialing program for regulatory compliance, executing policies and procedures for accurate application processing, and facilitating the Credentialing Committee. The role also involves acting as a liaison with state boards and health plans, analyzing application trends, ensuring department deadlines are met, developing policies and training documentation, and managing the credentialing platform's configuration and maintenance.

Skills

Credentialing
Enrollment
Provider Licensure
Medicaid Enrollment
Health Plan Credentialing
Re-Credentialing
Delegated Credentialing Program
Credentialing Committee
Primary Source Verifications
Regulatory Compliance
Reporting
Staff Management
Process Improvement

Imagine Pediatrics

24/7 virtual pediatric care and support

About Imagine Pediatrics

Imagine Pediatrics offers 24/7 virtual pediatric care customized for children with medical complexity, providing unlimited access to care via messaging, phone call, or video visit, and coordinating with the child's existing care team. Their multidisciplinary team of pediatricians, nurses, social workers, and care coordinators delivers high-quality, virtual-first care and support, with services currently available in Texas and Florida.

220 Athens Way #240, Nashville, TN 37228, USAHeadquarters
2022Year Founded
$5MTotal Funding
SEEDCompany Stage
51-200Employees

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