<p>Position Summary</p> <p>The Credentialing Manager oversees the end-to-end credentialing, recredentialing, and privileging processes for all licensed clinical staff at The Dimock Center, ensuring compliance with HRSA, Joint Commission, NCQA, state, and federal regulatory requirements. This role manages provider credentialing files, maintains accurate records in credentialing databases, coordinates with internal departments and external agencies, and ensures timely completion of all credentialing activities to support patient safety and operational readiness.</p> <p>The Credentialing Manager also facilitates the Credentialing Committee, ensuring all provider applications and renewals are reviewed, documented, and approved in accordance with organizational bylaws and regulatory standards.</p> <p>Additionally, this individual serves as the primary point of contact for external partners to assist in ensuring appropriate credentialing and privileging of our providers.</p> <p>Salary: The salary target range is $100,000 to $115,000 per year.</p> <p>Essential Duties & Responsibilities</p> <p>Credentialing & Recredentialing</p> <ul> <li> <p>Manage and execute the full lifecycle of credentialing and recredentialing for all clinical staff at the Health Center and Addiction Medicine Division.</p> </li><li> <p>Oversee privileging process in accordance with organizational policies and applicable accrediting body standards.</p> </li><li> <p>Ensure all clinical staff credentialing files are accurate, complete, and meet internal and external compliance standards.</p> </li><li> <p>Maintain credentialing database(s) and generate reports for Associate Chief Compliance & Enterprise Risk Officer, regulatory agencies, and audits.</p> </li></ul> <p>Compliance & Regulatory Oversight</p> <ul> <li> <p>Ensure compliance with HRSA, NCQA, Joint Commission, CMS, OSHA, HIPAA, and other applicable regulations.</p> </li><li> <p>Monitor license, certification, and DEA expirations; coordinate timely renewals.</p> </li><li> <p>Stay informed of changes in credentialing requirements and update policies, procedures, and systems accordingly.</p> </li><li> <p>Prepare for and participate in audits and site visits by regulatory and accrediting bodies.</p> </li></ul> <p>Credentialing Committee Facilitation</p> <ul> <li> <p>Prepare and distribute Credentialing Committee agendas, clinical staff files, and supporting documentation in advance of meetings.</p> </li><li> <p>Present credentialing and privileging recommendations to the Committee.</p> </li><li> <p>Record meeting minutes, track follow-up actions, and ensure timely documentation of Committee decisions.</p> </li><li> <p>Ensure all Credentialing Committee activities meet organizational bylaws, HRSA requirements, and accrediting body standards.</p> </li></ul> <p>External Partner Coordination</p> <ul> <li> <p>Serve as the primary point of contact for external partners regarding credentialing and privileging requirements for providers.</p> </li><li> <p>Coordinate with partner institutions to exchange necessary documentation, verify credentials, and ensure compliance with both organizations standards.</p> </li><li> <p>Address and resolve credentialing-related issues in collaboration with partner organizations.</p> </li></ul> <p>Collaboration & Communication</p> <ul> <li> <p>Serve as the primary liaison between clinical staff members, internal departments, and insurance payers.</p> </li><li> <p>Partner with HR, Compliance, and Clinical Leadership to ensure seamless onboarding and privileging of new hires.</p> </li><li> <p>Respond promptly to inquiries regarding credentialing status, requirements, and timelines.</p> </li></ul> <p>Process Improvement</p> <ul> <li> <p>Identify opportunities to improve efficiency, accuracy, and turnaround times in credentialing processes.</p> </li><li> <p>Implement technology solutions, tracking systems, and reporting tools to enhance performance.</p> </li><li> <p>Develop and deliver training to staff involved in credentialing-related processes.</p> </li></ul> <p>Required Qualifications</p> <ul> <li> <p>Bachelors degree in healthcare administration, business administration, or related field; equivalent experience may be considered.</p> </li><li> <p>Minimum 35 years of credentialing experience in a healthcare setting, preferably within an FQHC, hospital, or multi-specialty group practice.</p> </li><li> <p>Strong knowledge of HRSA, NCQA, Joint Commission, CMS, and state-specific credentialing standards.</p> </li><li> <p>Proficiency with credentialing databases and Microsoft Office Suite.</p> </li><li> <p>Excellent attention to detail, organizational, and problem-solving skills.</p> </li><li> <p>Ability to manage multiple priorities and meet strict deadlines.</p> </li></ul> <p>Preferred Qualifications</p> <ul> <li> <p>Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Staff Management (CPMSM) credential.</p> </li><li> <p>Experience with UDS reporting and FQHC-specific compliance requirements.</p> </li><li> <p>Familiarity with insurance payer enrollment processes.</p> </li></ul> <p>Working Conditions</p> <ul> <li> <p>Standard office environment with occasional need to travel to clinic sites.</p> </li><li> <p>May require extended hours during audit periods or deadlines.</p> </li></ul> <p>Physical Requirements</p> <ul> <li> <p>Prolonged periods of sitting at a desk and working on a computer.</p> </li><li> <p>Ability to lift up to 15 pounds as needed for file or supply management.</p> </li></ul>