Payer Credentialing Manager

🕒 July 23

🚗 Michigan – Remote

🚗 Michigan – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 43%

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.

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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. • Liaise 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. • Streamline provider onboarding to reduce risk and support patient safety.

🎯 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. • Employee must be able to perform the essential functions of this position satisfactorily, with or without a reasonable accommodation.

🏖️ 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