Payer Credentialing Manager

Job not on LinkedIn

🕒 July 23

🚗 Michigan – Remote

🚗 Michigan – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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Theoria Medical

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

⚕️ Healthcare Insurance

☁️ SaaS

Healthcare • Healthcare Insurance • SaaS

Theoria Medical is a leader in tech-enabled, value-based primary care, revolutionizing healthcare for senior living communities nationwide. The company employs a fully integrated model of care, combining primary care services with the latest technological advancements to offer a holistic and impactful healthcare experience for seniors. Their innovative offerings include remote patient monitoring, medical directorship, on-site medical staff, telemedicine, and workflow optimizations, all anchored by pioneering technologies like ChartEasy, ChatEasy, and ProphEasy. Theoria Medical is committed to enhancing patient outcomes through digital innovation and serves patients in skilled nursing, assisted living, and independent living settings across the United States.

📋 Description

• Oversee the processing of initial payer applications for health professionals, ensuring compliance with national accreditation standards and state/federal regulations. • Maintain and manage payer credentialing databases and electronic records, ensuring accuracy, confidentiality, and audit readiness. • Liaison with medical staff leadership, payers, licensure boards, and regulatory agencies to resolve credentialing issues promptly. • Supervise payer credentialing staff by coordinating workloads, providing training, monitoring performance, and ensuring quality outcomes. • Conduct regular audits of payer credentialing processes to identify gaps, implement corrective actions, and drive continuous improvement.

🎯 Requirements

• Bachelor’s degree in healthcare administration, business, or related field. • Minimum of 3 years in payer credentialing or healthcare administration. • 1–3 years in a supervisory or managerial role. • Demonstrated experience with payer enrollment processes. • Hands-on experience with payer credentialing systems (e.g., CAQH, Medallion). • Strong knowledge of databases and Microsoft Office applications (Excel, Access, Word). • Strong organizational skills, attention to detail, communication, problem-solving, and knowledge of regulatory guidelines.

🏖️ Benefits

• Competitive salary • 401(k) with employer match • Health, dental, and vision insurance • PTO + paid holidays • Life insurance coverage • Remote flexibility with a national legal scope