Manager, Credentialing

Job not on LinkedIn

🕒 5 days ago

🏄 California – Remote

🏄 California – Remote

💵 $62.3k - $80k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 1%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Altais

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2019

🏥 Healthcare

👥 B2C

🧘 Wellness

Healthcare • B2C • Wellness

Altais is a California-based healthcare provider network that unifies multiple medical brands to offer coordinated primary care, urgent care, specialty services, hospitals and labs, and mental and senior health across Northern and Southern California. The organization supports physicians and care teams with technology-enabled patient portals and value-based care partnerships, serving patients directly while also working with providers and partners to improve access, affordability, and care coordination.

📋 Description

• Directly supervise day-to-day operations of the credentialing function • Support delegated credentialing functions for Health Plan Partners and all lines of business • Manage the credentialing program for Altais affiliated entities, employed clinicians, clinical-service vendors, and MSO services clients • Administer credentialing functions to meet medical group, health plan, and NCQA requirements • Maintain, develop, and implement credentialing processes and procedures aligned with regulations and compliance requirements • Oversee interdependencies between departments and assess impacts on providers and the Credentialing team • Provide leadership and coaching to credentialing team staff • Process credentialing applications accurately and promptly • Manage preparation of materials and files for external payor and governmental audits • Manage relationships with health plan delegation oversight committee members • Manage initial and re-credentialing review by the Clinical Advisory Group for exception physicians • Manage claims, appeals, and peer review physician documentation for the Clinical Advisory Group • Audit the credentialing database and verify provider data and database modifications • Own the end-to-end delegated credentialing process • Develop functional, market-level, and/or site strategy, plans, production, and organizational priorities • Identify and resolve technical, operational, and organizational problems outside the team • Serve as SME for business requirements for sPayer

🎯 Requirements

• Bachelor’s degree or equivalent to 4 year university degree, preferably in healthcare related field of study • 5+ years professional experience working in credentialing, in a managed care setting required • 1+ year of management experience in Credentialing • Must be eligible to take National Association Medical Staff Services (NAMSS), Certified Provider Credentialing Specialist exam within 18 months of employment • NAMSS Credentialing certification preferred • External hires must pass a background check/drug screen

🏖️ Benefits

• Excellent medical, vision, and dental coverage • 401k savings plan with a company match • Flexible time off • 9 Paid Holidays • Competitive compensation package • Background check/drug screen for external hires