Credentialing Manager

Job not on LinkedIn

🔥 15 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 12%

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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Bridgeview Eye Partners

WebsiteLinkedInAll Job Openings

501 - 1000 employees

💼 Consulting

📦 Logistics

🏥 Healthcare

Consulting • Logistics • Healthcare

Bridgeview Eye Partners is a physician-led management services organization that partners with independent eye care practices to deliver full-scope, integrated eye care. It offers administrative support, strategic growth resources, financial backing, and access to ambulatory surgery centers and provider networks while preserving each practice's brand and clinical autonomy. Headquartered in Wabash, Indiana, Bridgeview focuses on improving patient outcomes and operational efficiency across rural and urban communities.

📋 Description

• Manage and execute the end-to-end credentialing life cycle, including initial credentialing, recredentialing, and expiration tracking • Oversee payer enrollment applications, PECOS updates, CAQH maintenance, NPPES records, and delegated agreements • Monitor and ensure compliance with NCQA, CMS, and commercial payer standards • Maintain an accurate credentialing database • Lead, supervise, and support Provider Enrollment Specialists • Ensure timely submission and follow-up of applications • Establish, document, and refine credentialing workflows, SOPs, and KPIs • Act as primary liaison with insurance plans to resolve enrollment delays or issues • Stay current with payer policy updates and state/federal regulations • Support credentialing-file audits • Provide weekly and monthly updates on credentialing status and turnaround times • Track and report pending expirations to avoid lapses • Prepare credentialing rosters and enrollment summaries • Champion the company's culture and commitment to patient care • Align strategic goals and resources to maximize profitability • Collaborate across the organization to identify needs and develop scalable solutions • Work on integration and post-acquisition teams as needed • Drive operational excellence to achieve financial goals • Build and lead collaborative teams, develop people, and link performance to business objectives • Guide and evaluate the work of other employees • Recruit, hire, train, motivate, and retain current and future leaders • Perform other duties as assigned

🎯 Requirements

• Bachelor’s degree or equivalent experience required • 3-5 years of credentialing experience • 2+ years in a supervisory role • Experience in optometry/ophthalmology or outpatient healthcare preferred • Experience in delegated credentialing and/or managed care contracting preferred • CPCS or CPMSM certification preferred • Strategic Relationship Management • Advanced Communication Skills • Influence & Negotiation Skills • Cross-Functional Collaboration • Process Improvement & Problem Solving • Project & Time Management • Proficiency in Microsoft Office • Strong knowledge of CPT, ICD-10, and HCPCS codes relevant to optometry/ophthalmology • Knowledge of insurance guidelines relevant to optometry/ophthalmology • Attention to detail • Professional Integrity • Ability to communicate effectively through verbal and written means • Ability to hear and understand spoken information in-person and via electronic means • Visual acuity to ensure the accuracy of work performed on screens and in documents • Ability to maintain focus and attention to detail for extended periods

🏖️ Benefits

• Remote position • Reasonable accommodations may be provided to qualified individuals with disabilities in accordance with applicable laws